Objective: The present work describes a modification of the standard reconstructive laryngectomy procedure, in order to address problems related to aspiration, and to improve functional results.Study Design and Setting: The study was conducted in Cairo University Hospital. Modified reconstructive laryngectomy (MRL) was performed on twelve patients who were scheduled for total laryngectomy. This technique allows for preservation of the superior laryngeal nerves, by fashioning folds of the pharyngeal mucosa to replace the arytenoids. This is followed by reconstruction of the airway through elevation and attachment of the remaining tracheal rings and/or cricoid to the hyoid bone and epiglottis.Results: MRL was successful in all of the twelve patients included in this preliminary study. All of the patients maintained comprehensible speech and were tracheotomy independent. Only one patient required total laryngectomy after eight months for local recurrence.Conclusion: MRL with excision of both arytenoid cartilages will expand the range of indications for conservative surgery in the management of cancer of the larynx.