Background: Diffusion-weighted magnetic resonance imaging (DW-MRI) has the ability of tissue characterization and can differentiate between benign and malignant tissues, including differentiation between benign post-radiotherapy changes and residual or recurrent malignancy. Objective: This study aimed to assess the role of diffusion-weighted magnetic resonance imaging in the evaluation of laryngeal and hypopharyngeal cancer as an initial diagnosis and the post-treatment surveillance protocol. Patients and methods: This study was a cross-sectional analytical study including twenty-five patients who presented with laryngeal or hypopharyngeal masses, thirteen cases were pretreatment cases, and twelve cases were post-treatment cases after completion of treatment. Seven cases had a hypopharyngeal origin, and eighteen cases had a laryngeal origin. The patients were assessed using history taking, a telescopic examination of the larynx and hypopharynx, computed tomography scanning, and diffusion-weighted magnetic resonance imaging on the neck. Direct laryngoscopic examination and biopsy taking from suspicious lesions were done. Biopsies were subjected to histopathological examination with a correlation between pathological and DW- MRI radiological results. Results: DW-MRI had a 100% sensitivity, 82.4 % specificity, and 88% accuracy compared to histopathological findings of biopsies from the studied group. There was a non-significant difference between DW-MRI and biopsy findings for either pretreatment or post-treatment cases of both laryngeal and hypopharyngeal origin of the lesions (p-value > 0.05 for all). Conclusion: DW-MRI is a sensitive tool for detecting laryngeal and hypopharyngeal cancers in new cases and excluding tumor residual after chemo-radiotherapy in cases with suspicious lesions after completion of treatment.