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Objectives Alternatives to surgical tracheostomy (AST) including submental (SMENI), submandibular (SMAN) and retromolar intubation (RMI) are fairly new and innovative airway procedures intended to avoid the complications of traditional surgical tracheostomy (ST). The study aimed to document the responses of junior Otorhinolaryngologists , regarding the awareness and training of AST as well as dealing with its complications when performed by other specialty. According to our knowledge there is no similar survey in the English literature. Methods Otorhinolaryngology residents/registrars in Ryad, Jeddah and Taif were surveyed between March 2013 and June 2014, enrolled and non-enrolled in Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) training programs doctors were included, Consultants and Senior Consultants were excluded. it is a qualitative and cross sectional study. Senior consultants were excluded from this qualitative and cross-sectional survey. Results A total of 59 participants responded to the questionnaire. Fifty-six (94.9%) were not familiar with AST, 52 (88.13%) supported the concept of AST, and 57 (96.6%) agreed the inclusion of AST in the ORL training programs. Thirty (50.8%) thought that AST will have a negative effects on ORL training, 47 (79.7%) would participate in any AST procedure, while 27 (45.8%) agreed to deal with AST complication if the procedure done by other specialty. Conclusion The majority of the surveyed ORL residents and registrars were not familiar with AST, nevertheless, agreed to undergo further training and to included it in the training programs. However, reserved dealing with related complications once done by other specialty we recommend that the supervising training body training body consider including AST in the curriculum. [ABSTRACT FROM AUTHOR]