A tracheo-innominate artery erosion in a 10-year-old boy 10 months after 80% burns in a gasoline explosion is reported. Tracheostomy was performed on the day of the burn to maintain an airway. Fatal hemorrhage from the erosion was the cause of death. Prevention can be achieved by: correct placement (second or third ring); aseptic tracheal toilet; positive nitrogen balance; and earliest possible tracheostomy removal.