Objective To optimize the St Mary's cluster nursing care after tracheotomy and evaluate it's clinical effectiveness. Methods St Mary's cluster nursing care after tracheotomy was optimized by using expert meeting method. From November 2016 to July 2017, a total of 100 hospitalized patients undergoing tracheotomy from Department of Otolaryngology and Department of Neurosurgery were selected as the research object. They were randomly divided into two groups by using Epidata software, 50 patients in each group. Patients in the observation group received cluster nursing care. And patients in the control group received conventional care. The average intubation duration, hospitalization expenses and incidence of complications were compared between the two groups, and the clinical effects were evaluated. Results The overall compliance of the observation group was 82.0%, which included 31 patients. The complication rate of the patients in the observation group was 6.5%, and the control group was 26.0%, the difference was statistically significant (χ2=4.846, P<0.05) . The retention time of the tracheal tube in the observation group was (23.03±6.22) d and the total hospitalization cost (19 804.00±4 401.70) yuan, which were all lower than those of the control group (t=-4.250, -8.570; P<0.01) . Conclusions After optimization, the St Mary's cluster nursing care after tracheotomy has better clinical effect, which makes it more valuable in clinical application. Key words: Tracheotomy; Cluster nursing care; Optimized plan