Thirty laryngeal cancer patients who were treated by surgery after radiation failure were evaluated. Pharyngocutaneous fistula developed after surgery in 40%. Three quarters of the fistufa were healed spontaneously, but in 3 cases(25%) D-P flap or pectoralis major myocutaneous flap were needed for reconstructian of pharynx and esophagus. Overall salvage rate by surgery for radiation failure is 60%, In stage lV cases, the survival rate was as low as 14%.