Objectives/Hypothesis: The study was performed to investigate the possible association between opium dependency and laryngeal cancer. Study Design: A hospital-based, group-matched, case-control study was presented. Methods: Ninety-eight patients with laryngeal cancer and 312 age- and gender-matched control subjects were selected at the otorhinolaryngology ward of a referral university-affiliated hospital. Data on cigarette smoking and alcohol and opium dependency were collected before surgery through semi-structured interview. Results: The crude odds ratios of laryngeal cancer were 15.07 (95% confidence interval [CI], 6.92–32.8 [P < .0001]) for cigarette smoking, 21.55 (95% CI, 10.54–44 [P < .0001]) for opium dependency, and 1.84 (95% CI, 1.008–3.38 [P < .048]) for male gender. Because of strong associations, a logistic regression model was prepared; the odds ratio for gender in the final model was 0.87 (95% CI, 0.39–1.92 [P = .11]). According to the results, it seemed that gender was not an independent risk factor for laryngeal cancer. Also, the adjusted odds ratios for smoking (5.21) (95% CI, 2.33–11.67 [P < .002]) and opium dependency (10.74) (95% CI, 5.76–20.02 [P < .002]) were lower than the crude odds ratios, but both ratios were significant. The mean patient ages were 55.1 years (SD = 12.05 y) in opium-dependent patients and 65.6 years (SD = 12.8 y) in opium-nondependent patients (P = .01). Conclusion: The results of the study suggest that opium dependency is not only an independent possible risk factor for laryngeal cancer but also significantly increases the likelihood of developing of the disease at a younger age.