Objective To explore the application value of ultrasound-guided percutaneous tracheotomy in multiple maxillofacial injuries with upper respiratory tract obstruction.Methods A total of 8 patients with multiple maxillofacial injuries complicated with acute upper respiratory tract obstruction were collected from May 2016 to October 2020. All of them were admitted to the Department of Critical Care Medicine of our hospital,who were presented with moderate to severe dyspnea.After tracheal intubation failed, they underwent emergency ultrasonics guided percutaneous dilatation tracheotomy.Results The puncture success rate was 100% in all 8 patients.The operation time was 5~9 min, with an average of 6 min.The amount of intraoperative bleeding was 4~12 mL; The success rate of the 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 application value.