Summary: Between 1981 and 1986, permanent tracheostomy was performed in 46 ponies and 1 adult Quarter Horse stallion. Permanent tracheostomies of 19 ponies and the horse were examined in June 1986 and evaluated for vertical length of stomal orifice (X̄ ∓SD = 25.0 ∓ 4.7 mm in the ponies and 55 mm in the horse), degree of tracheal obstruction (0/20), regrowth and apposition of epidermis (3/20 ), and whether or not stomal airflow occurred with nasal occlusion (20/20 ). In addition, the animals were evaluated to determine whether they developed dyspnea (0/20) during exercise, and the number of months since tracheal surgery and (X̄∓SD = 32.2 ∓ 17.2 months) was calculated. Records of the other 27 ponies were evaluated. Six of the 27 were not dyspneic with exercise at their last routine physical examination. Twenty-one ponies had died or been euthanatized, but only 5 of these deaths were attributed to complications associated with the respiratory tract; 3 ponies had collapsing tracheas, and 2 had chronic obstructive pulmonary disease. The permanent tracheostomy technique described provided a functional and cosmetic airway and was associated with a low rate of complications.