Background Conventional tracheostomy and percutaneous dilatational tracheostomy (PDT) present risks of exposing health care workers to coronavirus disease (COVID‐19). We report a hybrid modified percutaneous dilatational tracheostomy (hybrid MPDT) to reduce this risk of COVID-19 aerosol transmission. Methods We performed tracheostomy using a hybrid MPDT involving a combination of conventional tracheostomy and PDT. Hybrid MPDT requires a small incision and minimal dissection like conventional tracheostomy, followed by PDT without bronchoscope guidance and the use of an endotracheal tube cuffed at cricoid. Results Hybrid MPDT was successfully performed in 20 patients with COVID‐19. The infection rate to medical staff was 0% and the average operation time was 6.45±1.02 min. Conclusion Hybrid MPDT may ensure rapid and safe airway management in critically ill COVID-19 patients.