【Abstract】Objective To explore the application value of ultrasound-guided percutaneous tracheotomy in multiple maxillofacial injuries with upper respiratory tract obstruction. Method Eight patients with multiple maxillofacial injuries complicated with acute upper respiratory tract obstruction were treated by the Department of Critical Care Medicine of our hospital from May, 2016 to October, 2020.After tracheal intubation failure, they underwent emergency ultrasonics guided percutaneous dilatation tracheotomy. Result Puncture for 8 patients was successful at one time, and success rate of puncture was 100%; The operation time was 5 ~ 9 min, with an average of 6 min.The amount of intraoperative bleeding was 4 ~ 12ml; The success rate of catheterization was 100%. None of the patients had surgery related complications. Conclusion For patients with multiple maxillofacial injuries complicated with acute upper respiratory tract obstruction, emergency color Doppler ultrasound-guided percutaneous dilated tracheotomy can not only quickly, effectively and safely open the airway after tracheal intubation failure，but also improve the success rate and reduce surgery-related complications, which has good clinical value.