OBJECTIVES: The aim of this study was to determine the role of preepiglottic space (PES) invasion in lymph node metastasis and prognosis in patients undergoing supracricoid partial laryngectomy (SCPL) with cricohyoidopexy (CHP). METHODS: A retrospective review of 42 previously untreated patients with squamous cell carcinoma of the larynx that underwent surgery was performed. The mean age of the subjects was 61.3 years, and the male-to-female ratio was 38:4. Regarding their pathological stages, there were 3, 8, 22, and 9 cases of stage T1 to T4, respectively. Concerning the disease stage of the cervical lymph nodes, there were 30, 5, 6, and 1 cases with N0 to N3, respectively. RESULTS: The PES invasion rate was 23.8% (10/42). Significant correlations were found between PES invasion and cervical lymph node metastasis (P=0.002). Seven of the 10 patients (70.0%) with PES invasion had cervical lymph node metastasis, whereas only 5 of the 32 patients (15.6%) without any evidence of PES invasion had lymph node metastasis. There was also a significant correlation of PES invasion with age (P=0.002) and T stage (P=0.030). However, there was no significant relationship between gender, primary tumor site, anterior commissure invasion, subglottic extension, paraglottic space invasion and PES invasion. There was a 5-year disease-specific survival of 70%. PES invasion served as a statistically significant prognostic factor for disease-specific survival (P=0.004). Cervical nodal metastasis (P=0.003) and subglottic extension (P=0.01) were also statistically significant prognostic factors associated with disease-specific survival. CONCLUSION: The PES invasion was significantly related to the cervical lymph node metastasis and prognosis in patients undergoing SCPL with CHP.