Objective: Review our clinical experiences in the treatment of large area burn. Discuss the timing and the indications of tracheotomy for the large area burn patients. Methods: By different tracheotomy timing the large area burn patients were divided into preventive and emergency tracheotomy. The tracheotomy operation time and the operation indications of two group patients were compared. Results: The preventive tracheotomy had 57 cases, while the emergency tracheotomy had 46 cases. The preventive tracheotomy for moderate and severe inhalation injury were 41 cases, 71.93%; emergency tracheotomy group with severe inhalation injury were 24 cases, 52.17%. The timing of preventive tracheotomy was (5.51+1.28) h, while the emergency tracheotomy operation time is (24.80+4.67) h. Conclusion: Severe large area burn patients should take the preventive tracheotomy. It’s high possibility that 24 h after injury the large area burn patients would have the airway obstruction. The indications for the tracheotomy are: a large number of respiratory sticky secretions, nose with large number of serum exudation and although during the oxygen therapy, the PaO2 of the patient was still not elevated. And the “fish mouth” lips and neck Escher formation also are the important operation indications for tracheotomy.