Pneumothorax complicating a tracheotomy is a rare event, but it should be clinically considered in order to the early treatment, mostly in urgent or pediatric cases. We report 2 cases in which pneumothorax complicated postoperatively the tracheotomy and required early clinic and radiologic diagnosis followed by a promptly and satisfactorily evacuated. We review the need to perform a chest X-Ray after every tracheotomy or only following those cases found to be at risk, as well some effective preventive measures.