Pharyngocutaneous or salivary fistula is one of the most common and troublesome complication in the early post-operative period following total laryngectomy operation. This essay includes an introduction to the subject and the aim of this work. It also includes review of literature of PCF. The worldwide relative incidence is documented. and the etiological predisposing factors are discussed in details. Preoperative causes include: irradiation, systemic affections, co-morbidity index and the presence of tracheostomy. The operative factors include the type of closure of the pharynx and types of sutures used. Postoperative factors include the type of feeding and the presence of surgical complications. Sequelae of PCF are mentioned. Prevention of fistula formation is discussed. The management of PCF is described in more details and the description of 2 different myocutaneous flaps namely the pectoralis major and latissimus dorsi are described in details, together with the delto-pectoral axial cutaneous flap