Previous thought was that total laryngectomy and difficulty with swallowing were incongruous. Patients were counseled that the loss of their larynx would leave them without a vocal source, but that swallowing would not be affected. Successful rehabilitation was defined as being cancer-free and regaining functional communication. Patients were not queried and frequently did not complain of dysphagia as long as they were able to maintain an oral diet. Knowledge has changed, and this article will focus on dysphagia in the patient with laryngectomy and will discuss anatomical sites to physiologic problems.