Between January 1980 to December 1985, 248 patients with advanced squamous cell carcinoma of the pyriform sinus were retrospectively analysed. Criteria for inclusion in the study were the following: no previous treatment and treatment combining total pharyngolaryngectomy and postoperative radiotherapy. Mean follow up was 5 years with a minimum of 3 years. Seventy-one patients had a local regional recurrence (27.4%). Clinical staging at presentation and residual tumor at the primary site after surgery were factors significantly associated with higher local failure rates. The 5 year survival rate was 33% and the median survival time was 32 months (plateau was reached after the 6th year). The most frequent severe complication observed was pharyngeal stenosis occurring in 6% of the cases. This study confirms the poor prognosis of squamous cell carcinoma of the pyriform sinus, in spite of the combination of radical surgery and high dose postoperative radiotherapy.