Objective: Tracheostomy is required in cases of severe Bronchopulmonary dysplasia (BPD) in preterm babies who need prolonged mechanical ventilation. There are no guidelines and consensus on the timing of placement of tracheostomy tube as well as timing for decannulation. The objective of our study is to identify the risk factors in the patients with the BPD which might contribute to prolonged tracheostomy tube need or delays decannulation. Method: A retrospective chart review of extreme low birth weight infants with severe BPD who had tracheostomy tube placed during their neonatal intensive care unit stay. Important variables prior to tracheostomy tube placement as well as after discharge from hospital were recorded. Results. A total of 18 patients were included. There was a predominance of male babies (66.6%) who required tracheostomy placement. tube. Male newborns (66.6%) who had a poor growth during NICU stay and small for gestational age (SGA) on weight percentile at one and two years of age, required longer time/duration on tracheostomy. SGA was defined as weight less than 10 th percentile on Fenton preemie growth curve. Babies who had pulmonary hypertension also required longer time of tracheostomy in situ. Conclusion: Poor growth trajectory especially in a male newborn and evidence of pulmonary hypertension in the BPD patients showed need of longer duration on tracheostomy prior to decannulation. Further studies with multicenter large sample size are recommended.