The outcome of a series of 68 patients over 75 years old with carcinoma of the larynx, and 33 patients over 75 years old with hypopharyngeal carcinoma managed by a single oncological team during a 10-year period was studied. Sixty-one of the patients with laryngeal carcinoma were treated with curative intent. The actuarial 3-year survival rate of the whole group was 45%. This contrasts with hypopharyngeal carcinoma in which we found a 3-year survival of 11% with only 17 of the 33 patients suitable for treatment with curative intent. In view of the anticipated poor prognosis of hypopharyngeal carcinoma in the elderly we conclude that treatment should be directed towards palliation without radical surgery whenever possible.