Introduction: The study aimed to assess and compare the vulnerability and severity of outcomes in patients who suffered self-extubation and accidental extubation during their stay in the ICU. Design: Prospective observational study. Setting: Sixteen-bedded mixed intensive care unit in a tertiary care hospital. Materials and Methods: All adult patients admitted in ICU with either an endotracheal tube or a tracheostomy were included in the study. The time and description of the type of unplanned extubation, the cause and severity of the incident and its impact on the course of the patient′s illness, the person who noted the incident first and how it was detected were noted. Results: The rate of unplanned extubation was 32 (1.42/100 tube days) in 552 intubated patients (2243 tube days). Of them, 26 patients suffered self-extubation while the rest six patients were accidentally extubated. Re-intubation was required in eight patients after self-extubation while it was needed in all the six patients of accidental extubation. Three patients of accidental extubation went on to develop respiratory arrest including one patient who developed cardiac arrest. Conclusion: The outcome of the patients who suffered self-extubation is better than those with accidental extubations.