The Coronavirus Disease (COVID-19) pandemic has led to an increase in the number of critically ill patients requiring intensive care unit admissions and mechanical ventilation. The sequential effect is that these patients may then require a tracheostomy. Tracheostomy guidelines were established to help minimise the risk of viral transmission to the personnel performing the procedure. Safety measures regarding preoperative planning, surgical technique and nursing care are important to minimise the risk of transmission to medical personnel. We describe our experience in conducting tracheostomies for two COVID-19 patients at a referral centre in Sabah, Malaysia.