A new respiratory illness the severe acute respiratory virus (Sars Cov2), was identified at the beginning of the new decade 2020. Severe cases present with respiratory distress and tracheostomy has been considered to play a role in their management. We present a report of a Tracheostomy performed on a Covid-19 patient and also a review of the relevant literature. A 62 year old man, was brought in on a transport ventilator with a endotracheal tube insitu. From a private clinic after testing positive for COVID-19. While on admission he desaturated further and subsequently had a tracheostomy done with marked improvement of the oxygen saturation immediate post operative period. However on the day following the tracheostomy, he desaturated suddenly, resuscitation was commenced immediately but proved abortive, Patient was later certified dead. Despite the unfavourable outcome, we believe the decision to perform the tracheostomy offered the patient a chance at survival.