<p>Salvage laryngectomy is fraught with additional challenges compared to upfront laryngectomy due to the effects of chemotherapy and radiation on tissue healing. This study aimed to analyse the perioperative parameters, outcome and complications of patients who have undergone salvage total laryngectomy and to evaluate the effect of using pectoralis major myocutaneous flap on post operative morbidity This is a retrospective study in which we analysed data of patients undergoing salvage laryngectomy for residual / recurrent laryngeal cancer after chemoradiotherapy in our institute in the period 2021–2022 with follow up details for one year. A total of 22 patients underwent salvage laryngectomy between 2021 and 22. Eight (36%) had pre existing comorbidities.13 patients (59%) underwent primary closure without flap, whereas in 9 patients (41%) pectoralis major myocutaneous flap was used used either for patch pharyngeal augmentation or as overlay. Post operatively, minor wound infection occurred in 6 patients(27%), pulmonary infection in 3 patients (14%), pharyngocutaneous fistula in 7 patients (31.8%). There was no mortality or disease recurrence in the follow up period of one year.Pharyngocutaneous fistula occurred in 6 out of 13 (46%) patients who underwent pharyngeal closure without flap, and in 1 out of 9 patients(11%) where flap was used. Salvage total laryngectomy has significant post operative morbidity, which can be minimized to a considerable extent by considering the use of pectoralis major myocutaneous flap for reinforcement.</p>