The question of clinically negative (No) neck in squamous cell carcinoma of the larynx has not been resolved satisfactorily (Collins 1989).In most institutions, a frequency of occult metastases exceeding 20% is considered to be sufficient to justify elective neck therapy (Snow 1993). Therefore, prevention of regional relapse could significantly reduce mortality in the presence of intercurrent disease process (Levedang, et al 1987). The issue of the use of elective surgery versus elective radiation ends not at which treatment modality is more beneficial, but which one is less harmful. The patient's age, general health, family support, reliability and patient's own wishes are important. It is impossible to compare elective neck dissection and elective nodal irradiation efficacy because the status of neck disease is unknown when elective irradiation is used.The accurate histological information on micrometastases in neck nodes in patients with clinically negative neck nodes is probably one of the prime factors that tilts the argument towards nodal dissection, apart from the lesser associated morbidity.