Reconstruction of the hypopharynx and upper esophagus after resection of advanced pyriform sinus cancer, is usually complicated and time-consuming. Laryngotracheal flap was used in hypopharyngoesophageal reconstruction for 26 elderly patients with advanced pyriform sinus cancer Pharyn-gocutaneous fistula developed in 5 patients and healed spontaneously without further surgery. Full diet was resumed in all the patients. The surgical technique and its advantages and disadvantages are discussed. The laryngotracheal flap in the reconstruction of hypopharyngoesophageal defect for elderly patients is a procedure of choice. Reconstruction of the hypopharynx and upper esophagus after resection of advanced pyriform sinus cancer, is usually complicated and time-consuming. Laryngotracheal flap was used in hypopharyngoesophageal reconstruction for 26 elderly patients with advanced pyriform sinus cancer Pharyn-gocutaneous fistula developed in 5 patients and healed spontaneously The laryngotracheal flap in the reconstruction of hypopharyngoesophageal defect for elderly patients is a procedure of choice. without further surgery. Full diet was resumed in all the patients. The surgical technique and its advantages and disadvantages are discussed.