Laryngeal cancer represents a challenge for the clinician from the time of diagnosis until the time of decision-making regarding disease management. Staging is based clinically, with endoscopic and radiological assistance. Once a diagnosis is made, the following factors are taken into consideration: organ preservation when possible, quality of life, voice quality, surgical team experience, and treatment cost-benefit. These decisions are based on studies with a poor level of evidence; however, with good results. For early disease stages, we have different options like open surgery, transoral laser surgery, and radiotherapy. For advance disease and salvage, organ preservation can be considered using a combination of these tools without affecting survival and offering a good quality of life. At present, new technologies are being developed such as the use of robotics in the treatment of these tumors, but wider experience and adequate instrumentation are being awaited.