The ProSeal Laryngeal Mask Airway is a supraglottic airway that aims to provide improved airway seal and separation of the gastrointestinal and respiratory tracts. We report two cases in which the ProSeal Laryngeal Mask Airway was used to initiate controlled ventilation in the intensive care unit and subsequently provide airway maintenance during percutaneous dilational tracheostomy. The first case involved a patient with a known difficult airway who had previously been impossible to intubate conventionally. In both cases, airway management and subsequent tracheostomy were performed without complication.