Radiation therapy is a well-established treatment for early squamous cell carcinoma of the larynx. However, the management of patients suspected to have persistant or recurrent disease may present both diagnostic and therapeutic dilemmas, particularly when laryngeal edema persists for months after conclusion of radiation therapy. We reviewed the outcome of 40 patients with laryngeal cancer who had surgical salvage after radiation failures at Korea Cancer Center Hospital from October, 1977 to August, 1987. The 2-years disease-free survival in this series was 73.6%. The 5-years actuarial survival was 63.0%. Total laryngectomy usually was necessary for surgical salvage.