Tracheostomy cannulation, introduced since 1952 as a means of long-term ventilatory support, has occasionally resulted in severe traumatic lesions of trachea and tracheoesophageal fistula. This case report consists of a tracheoesophageal fistula developed 115 days after tracheostomy cannulation in a 61 year old driver with C.V.A. The causative factor in this patient seemed to be the tip of tracheostomy cannulation.