Abnormal tone in the pharyngo-oesophageal (PO) segment may lead to failure in developing oesophageal speech. Videofluoroscopy may give a qualitative assessment of the PO segment but is expensive, time consuming and lacks quantification. A custom built PO segment manometer was therefore assessed as a means of predicting eventual oesophageal speech outcome. Two groups of patientswere studied. In group 1(18 patients) the PO segment pressures were compared to their videofluoroscopy findings. Videofluoroscopy categorized the patients into four groups. The PO pressurescorresponded to this grouping, pressures above 20 mmHg being associated with voice failure. Ingroup 2 (12 patients) the PO pressures in the early post-operative period were compared to their eventual speech outcome. In all cases the pressures predicted the eventual speech outcome. The pressure manometer is a simple, cheap and portable device which is a reliable screening testto predict the potential for oesophageal speech.