The Medical College of Georgia Level I Trauma Center admitted 5603 adult trauma patients from January 1, 1989 through June 30, 1993. Cricothyrotomy was required in 66 of 525 patients who required emergency airway control but could not be intubated nonsurgically in an expeditious manner. There were three major complications (thyroid cartilage laceration, significant hemorrhage, and failure to obtain a surgical airway) involving two patients, but each resolved without sequelae. Twenty-six patients with cricothyrotomy survived their hospital course, of which seven had decannulation of the cricothyrotomy without further airway procedures, and 19 had conversion to tracheostomy. No patient had clinically significant morbidity from the cricothyrotomy, whether with or without a subsequent tracheostomy. Surgical cricothyrotomy remains an important technique with low morbidity for selected trauma victims needing emergency airway control.