Objectives: We evaluated the effect of neck metastasis on the survival rate of patients who undervvent surgery for laryngeal cancer. Patients and Methods: A total of 256 patients who had under-gone surgery betvveen 1995 and 1999 were retrospectively revievved. Of these, 186 patients (72%; 185 males, 1 female; mean age 57.5 years) who were accessible for follow-up were evaluated with respect to the localization and type of the pri-mary tümör, neck metastasis, surgical pracedures, and the survival. Survival rates were determined by the Kaplan-Meier method and compared by the log-rank test. The rates of neck metastasis and extracapsular spread in survivors and non-survivors were compared with the use of the chi-square test. The minimum follow-up period was two years (mean 41.2 months). Results: Twenty nine patients died from locoregional recurrences or distant metastasis and six patients died from other causes. The cumulative survival period was 69 months (75 months and 54 months with or without neck metastasis, respectively; log rank test 27.96, p<0.0001). The rates of neck metastasis and extracapsular spread in sur-vivors (22%, 33/151; 7%, 10/151) and non-survivors (69%, 20/29; 59%, 17/29) were significantly different (p<0.001). Conclusion: Neck metastasis and cervical recurrence were found as the most important factors affecting the results of laryngeal cancer surgery.