This is a prospective study which compares the efficacy of cricotracheal resection (CTR) with end-to-end anastomosis and cricoid collar technique in severe laryngotracheal stenosis. 23 patients were selected and arranged into 2 groups from 2007 to 2010. All patients were Cotton’s grade 3 or 4 and McCaffrey stage III. Group I (17 patients) underwent CTR while group II (6 patients) were operated with the collar technique. All patients underwent laryngeal release procedures. 15 patients (88.2%) were successfully decannulated in group I whereas only one patient (16.7%) was decannulated in group II. Postoperative cord paralysis was noted in 3 patients of group I and in one patient of group II. CTR is the procedure of choice for severe laryngotracheal stenosis rather than cricoid collar owing to its high decannulation rate and fewer complications.