Bedside percutaneous tracheostomy (PCT) for patients in intensive care units (ICU) is gaining popularity. Recently, the use of a laryngeal mask airway (LMA) to facilitate PCT has been described. We present a series of 18 patients where an LMA was inserted prior to PCT. This was successful in all but one patient. PCT could not be performed in this patient as oxygen desaturation had developed after inserting the LMA. The reason for this was probably an oedematous larynx, secondary to long-term intubation. Major bleeding in two patients [one of whom required packed red blood cell (RBC) transfusion] required surgical intervention and two patients had minor bleeding. No complications were related to the insertion or presence of the LMA during PCT, with the exception of the one patient cited above. The use of an LMA during PCT is a method of treatment worth noting in ICU patients. This technique may provide suitable conditions for performing PCT and is free from the complications associated with the presence of an endotracheal tube.