Percutaneous dilational tracheotomy (PDT) and conventional tracheostomy are still competing methods to provide an airway for intensive care patients requiring assisted ventilation. Tracheal stenosis is a late complication for any tracheostomy and long-term intubation. However, late complications in PDT have not been extensively studied. This article is the first to report on total atresia of the subglottic larynx and cervical trachea after PDT. The dimension of the lesion is visualized by three-dimensional reconstructed CT scan. The etiology of this condition is discussed.