Background : Airway is the prime priority in basic life support. Tracheostomy is one of the most common procedures done to secure airway, prevent aspiration and provide ventilator support in critically ill patients. The tracheostomised patients suffer from psychosocial problems like fear, anxiety, stress, frustration and communication difficulties. Its impact on patients andtheir care givers is under reported. This study offers insight into these psychosocial issues in an Indian context, which may contribute todevelop strategies to enhance the quality of life in tracheostomised patients. It aims to provide support to alleviate social isolation, reduce stigma, and improve compliance with ongoing treatment. Methodology :This observational study was conducted in all tracheostomised patients and their primary care.All tracheostomised patients and their primary caregivers were recruited in the study were followed up for 3 months. Patients were interviewed thrice during follow-up period- on postoperative day (POD)-30, POD-60 and POD-90. Psychosocial status and Quality Of Life (QOL) in patients was assessed by using Perceived Stress Scale (PSS) and World Health organization Quality of life-BREF(WHOQOL-BREF) version Questionnaire. Assessment of stress in caregivers was done by using Kingston Care Giver stress scale (KCGSS). Results: The majority of the patients in our study were males (52) compared to females (34). Whereas most caregivers were females (56). Elective tracheostomy was performed in 68 cases, while 18 required emergency tracheostomy. At 30 days postsurgery,75.59% patients experienced high stress, which decreased to 62.8% at 60 days and further declined to 25.59% at 90 days. This indicates that, as the postoperative period progressed from 30 to 90 days, the proportion of patients with high stress declined. The median scores across all domains-physical, psychological, social, and environmental health-increased over time, with the results being statistically significant (p < 0.001). Tube related issues included LRTI(12.7%), tube blockage(11.6%) excessive secretions (15.2 %)accidental decannulation (11.6 %), bleeding from stomal granulations (23.2%) and dysphagia(5.8%). Anger (33.2%), frustration (12.5%), and sleep deprivation (43.2%) were more commonly observed in the first month post-tracheostomy. 4.6% were not socialising to avoid embarrassment and social stigma. Majority of the caregivers were spouses (86.4%) and most of them were females 65.1%. and non-earning members of the family and 45.3% had financial issues. 28% of the caregivers had additional responsibility of contribution to the economy. Conclusion : Our study shows tracheostomy greatly impacts patients' and caregivers' quality of life, particularly in rural, illiterate populations. Emergency procedures increase stress due to insufficient preoperative counselling. Stress decreases over time with improved coping. Comprehensive support, including preoperative counselling and caregiver training, is essential to mitigate these effects.