The manual for doctors gives indications for the performance of tracheostomy in neurosurgical patients with various variants of respiratory and swallowing disorders. Methods of operation, care for tracheostomy patients and the timing of decanulation are also proposed. On a large clinical material, the optimal timing of tracheostomy operation is determined. The issues of prevention and treatment of possible complications . are considered in detail The most rational and modern methods of tracheostomy are proposed, significantly reducing or eliminating the development of complications.