This chapter provides a summary of a landmark study in surgical critical care. Does early tracheostomy reduce mortality in ventilated critically ill patients? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case on discussing the option of a tracheostomy with the family of a critically ill patient.