Objective: In the current study, our primary aim is to compare complication rates between using ProSeal laryngeal mask airway (P-LMA) and endotracheal tube (ETT) in bronchoscopy-guided percutaneous dilatational tracheostomy (PDT) procedure. Our secondary aim is to compare the processing time of these two techniques. Methods: Sixty-one adult patients who were intubated in the intensive care unit and scheduled for PDT due to the need for long-term mechanical ventilation were included in the study. The patients were randomly divided into ETT group or P-LMA group under bronchoscopy guidance. Complications related to the procedures and the duration of each procedure were recorded. Hemodynamic measurements, oxygen saturation, arterial blood gas analysis, preferred mechanical ventilation mode, positive end expiratory pressure and mean airway pressure values were recorded before PDT, and 30 minutes after the procedure. Results: A total of 61 cases, 23 (38%) female and 38 (62%) male, participated in the study. Regarding the complication rates between the groups, we encountered more complications in the ETT group and the most common complication was puncture of the cuff of the intubation tube. The procedure time was also significantly shorter in the P-LMA group (P-LMA; 2.5 min, ETT; 3.6 min). Conclusion: Using P-LMA for PDT under bronchoscopy caused lower complication rate than using ETT. In a addition the duration of PDT procedure was shorter in P-LMA group than ETT group. Keywords: Percutaneous dilatational tracheostomy, bronchoscopy, laryngeal mask