For patients with early laryngeal cancer, primary radiotherapy is a well established treatment method, achieving a local control rate between 70% and more than 90% with a risk of serious toxicity of less than 2%. Including salvage surgery of irradiation failure, tumor specific survival rate is higher than 90%. In patients with moderately advanced or favorable subgroups of advanced laryngeal cancer, primary radiotherapy with some form of hyperfractionated or accelerated irradiation achieves a local control rate approximately between 50 and 70%. Including salvage surgery of radiation failure, survival is equivalent to primary surgery with about 65% of the surviving patients retaining an intact larynx. Areas of intensive research are: Altered fractionation of irradiation with adaptation to the individual tumor kinetics, combination with chemotherapy and newer radiation sensitizers as well as follow-up and chemopreven-tion studies for early diagnosis and a decrease of the frequent secondary tumors.