Objective:To explore the factors which lead to pharyngo-cutaneous fistula after total laryngectomy.Method:A retrospective study of 125 patients who underwent total laryngectomy during a 16-year period was carried out.Result:The rate of post-laryngectomy pharyngo-cutaneous fistula is 16.0% (20/125),it appears reduced tendency.With single-factor analysis,the factors effect on the rate of post-laryngectomy pharyngo-cutaneous fistula include clinical tumor stage,tumor types,pre-operative radiotherapy dose,intra-operative blood transfusion,operative duration.With all varible logistic model analysis,the factors effect on the rate of pharyngo-cutaneous fistula are clinical tumor stage and pre-operative radiotherapy dose,but pre-operative radiotherapy is very possible to be a risk factor (P=0.0566).With logistic model stepwise regression analysis,the factors effect on the rate of pharyngo-cutaneous fistula are clinical tumor stage and operative duration.Conclusion:Pharyngo-cutaneous fistula appears easily in patients with T3、T4 tumor,and have pre-operative radiotherapy, especially have large dose preradiotherapy.For these high risk patients,the duration of operation should be as short as possible to reduce the rate of post-laryngectomy pharyngo-cutaneous fistula.