A palliative tracheostomy or pharyngostoma provides a permanent or semi‐permanent airway bypass for patients with inoperable tumors, severe stenosis, or recurrent obstructions of the upper aerodigestive tract. Unlike acute tracheostomy, the goal is sustained comfort: the stoma may be fashioned lower on the airway (pharyngostoma) to optimize speech or allow direct suctioning of pharyngeal secretions.