Objective: The objective of this study is to investigate T4 laryngeal cancer cases with skin infiltration regarding survival and different variables that may influence the survival. Study design: This is a retrospective analytic study. Material and methods: This study included 14 patients suffering from laryngeal carcinoma with tumor extending to involve the skin of the front of the neck. Total laryngectomy was performed for all patients together with excision of the overlying skin and pectoralis major myocutaneous flap (PMMF) was used for reconstruction of the skin defect in all cases. Analysis of the pre-operative, operative, post-operative and follow up patients' data was done. The one, 2, 3 and 5 years survival rates were estimated. Results: The overall mean survival time for all cases was 51.1±8.3 months. The mean survival time for cases with recurrent disease was 16.4±3.5 months and for cases without recurrent disease was 70.7±6 months. The one,2,3 and 5 years survival rates were 92.9%, 71.4%, 64.3% and 50% respectively. The univariate analysis revealed that previous treatment before definitive surgery was the only variable that had a statistical influence on the overall 5 years survival rate (P=0.046). Conclusion: Extended laryngectomy with skin removal offers reasonable 5 years survival rate for T4 laryngeal cancer cases with skin invasion and reconstruction of the neck skin defect with a pectoralis major myocutaneous flap is a reliable method of repair.