The clinical diagnosis of laryngoceles simultaneously occurring with squamous cell carcinoma of the larynx is infrequent; however, when specimens from patients with laryngeal cancer have been examined closely, the two entities have been associated in 4.9% to 28.8% of cases. Despite this apparent relationship, the literature has failed to address the potential impact of a concurrent laryngocele on surgical decision making. Also, the wide variation in the reported rates of simultaneous occurrence of these two entities is unexplained. We performed whole-organ histo-pathologic analysis on a laryngeal specimen with bilateral external laryngoceles associated with squamous cell carcinoma and correlated this to computed tomography findings. Based on this information and other reports concerning the pattern of spread of carcinoma within laryngoceles, it appears that su-praglottic laryngectomy is oncologically sound in the presence of a laryngocele as long as the usual criteria for this procedure are met.