In recent years, the improvement in results in terms of survival in the treatment of laryngeal and hypopharyngeal cancer at the same stage has been rather poor. Therefore, oncologists have tried to improve the quality of life through a decrease in morbidity while not decreasing the treatment efficacy. In particular, the objective was to preserve with noninvasive procedures the anatomy and function of the larynx and hypopharynx while not affecting the possible cure. The refinement on diagnostic, surgical and anesthetic procedures, the potential of modern radiotherapy, the acquisition of new knowledge in medical oncology have allowed the planning of combined modality therapy protocols aimed at organ preservation in many patients. Concurrent radiation and chemotherapy in patients with locally advanced disease is a clinical problem still under study. Results of some phase I and III studies have shown the efficacy of radiochemotherapy, at times with a non negligible toxicity involving healthy tissues, but with a real effective improvement in survival and organ preservation in laryngeal and hypopharyngeal cancer.