Evaluation of patients with laryngeal and hypopharyngeal tumors is based on multidetector CT imaging. The cervicomediastinal CT protocol and general guidelines with regards to planning and acquisition will be detailed. The primary role of imaging is accurate tumor staging but also detection of possible tumor extension to the superior aerodigestive tract and nodal areas. Therefore, images are acquired from the skull base to the cervicomediastinal junction. A chest CT must also be performed to look for distant metastases or other primary tumor. Deep tumor extension, detected only by imaging, is very important to consider for therapeutic planning: surgery or chemoradiotherapy. In case of surgery, accurate evaluation of tumor extension is of great importance to determine whether to perform partial or total surgery. Cervical nodal metastases are very common with laryngeal and hypopharyngeal carcinomas, and accurate staging of nodal disease is important.