Amongst the myriad of problems that patients with severe neurodisability encounter is that of recurrent airway obstructions and intractable aspiration pneumonias due to dysfunction of the protective mechanism of the larynx. Here, we describe the use of total laryngectomy as a surgical option for these patients. Case was 24 year old male with severe cerebral palsy suffering from recurrent episodes of airway obstruction and aspiration pneumonia. In the severely disabled patient with recurrent aspiration pneumonias, total laryngectomy may present as a viable option, especially in those patients who have been previously incapable of effective verbal communication.