Tracheostomy can be associated with major complications at any stage of the procedure. Early complications include hemorrhage, embolisms, pneumothorax, pneumomediastinum, air embolism, and death.1,2 Late complications are also frequent, such as granuloma, pain, acute obstruction, tracheoinnominate artery fistula, and death.3,4 Until now, vertebral body erosion was not known as a possible complication of tracheostomy. We describe a patient with tracheostomy associated with erosion and compression of the second and the third vertebral bodies owing to cannula conflict. To our knowledge, this is the first documented case of vertebral body erosion due to a tracheostomy cannula.