Management of patients with carcinoma of the larynx should systematically include an appropriate treatment of lymph nodes according to the TNM stage. One of the most controversial points of the treatment in these patients is the management of the clinically negative neck (N0). A retrospective study of 295 patients with laryngeal carcinoma and N0 neck undergoing treatment in our centre between 1983 and 1993 is presented. We observed a significant decrease in the survival of clinically N0 patients with histologically affected lymphnodes. Lymphadenopathy was more frequently detected in patients with supraglottic tumours (38 per cent) when compared to glottic tumours (16 per cent). In our experience, routine bilateral and unilateral dissection of N0 necks in all supraglottic tumours and in T3–T4 glottic tumours, respectively, is the most beneficial approach for patients in terms of survival.