The TNM staging system allows us to correctly stage the laryngeal cancer and offer to the patient the best surgical options. Besides the tumor features, when choosing the best treatment, other patient-related variables have necessarily to be considered, such as the patient’s age, general conditions, compliance to postoperative rehabilitation, and suitability for any adjuvant treatment. Laryngeal surgery is a patient-tailored surgery and, after a meticulous selection of fitting patients, different surgical options can be proposed.