| Objective: To investigate the effect and safety of optimal suction therapy on ICU tracheotomy patients. Methods: A total of 79 patients with tracheotomy who underwent ICU in our hospital from January 2018 to March 2019 were randomly divided into observation group (n=40) and control group (n=39). The suction method, while giving routine nursing measures, the observation group was given a shallow suction method combined with fiberoptic bronchial optimization program, and comprehensive nursing intervention was used to compare the two groups of nursing effects, the incidence of lung infection and tracheal mucosal bleeding, staying ICU time, mechanical ventilation time and hospital stay. Results: The incidence of tracheal mucosal hemorrhage in the observation group was 15.0% and the incidence of pulmonary infection was 25.0%, which was significantly lower than that in the control group. The difference was significant (P＜0.05). The ICU time (6.94±1.32) d and mechanical ventilation time (3.79± 1.21)d, hospitalization time (14.62±2.11) d were shorter than the control group, the difference was significant, P＜0.05. Conclusion: Through ICU tracheotomy patients to optimize the suction program, combined with comprehensive nursing intervention, the effect is significant, shorten the ICU time, mechanical ventilation time and hospital stay, high safety, reduce the incidence of lung infection and tracheal mucosal bleeding.