BACKGROUND: During the ongoing pandemic of COVID-19, tracheotomy under emergency situation is considered a high-risk procedure that causes probable expose to aerosolized secretion. SUMMARY: We reviewed our case and previous reports, and summarized a detailed protocol that is needed to protect medical staffs who perform tracheotomy under the COVID-19 pandemic, considering the patient's condition, experience of medical staff members, and available facilities and equipment. Key Messages: For efficient protection of medical staff who perform tracheotomy under the COVID-19 pandemic period, we suggest that the following needs to be considered: assessment of patient's condition (COVID-19 infection and the airway problem), route (safest route to the operating room), experienced surgical team, negative-pressure isolation facility and appliance (personal protective equipment) availability, and safe and appropriate post-tracheotomy care.