Objective-The incidence of tracheostomy-dependence in critically ill children is increasing in the US. We do not know the impact of this decision on parental outcomes. We aimed to determine the incidence of decisional conflict and regret and explore the impact on quality of life (QoL) among parents considering tracheostomy placement for their child. Design-prospective, mixed-methods longitudinal studySetting-Pediatric, cardiac, and neonatal intensive care units of a single quaternary medical center. Interventions-none.Measurements and Main Results-Parents completed a Decisional Conflict survey at the time of tracheostomy decision and Decisional Regret and quality of life surveys at two weeks and three months after the decision regarding tracheostomy placement was made. We enrolled 39 parents, of which 25 completed surveys at all three time points. Thirty five of 39 (89.7%) reported at least some decisional conflict, most commonly from feeling uninformed and pressured to make a decision. At two weeks, 13/25 (52%) parents reported regret, which increased to 18/25 participants (72%) at 3-months. Regret stemmed from feeling uninformed, ill-chosen timing of placement and perceptions of inadequate medical care. At two weeks the QoL score was in the