During the past decades, treatment of laryngeal cancer has changed substantially, mainly due to the advent of novel approaches such as combined modality therapy as well as improvements in radiotherapeutic techniques. Locoregionally advanced disease in particular, which resulted in high recurrence and mortality rates, is now associated with long-term disease-free survival in a large proportion of cases. Moreover, with multimodality treatment, larynx preservation is now possible in most patients. There are varied regimens in use for patients with advanced disease, but at the same time the multitude of options can plague the clinician when trying to select the most appropriate one. This article will attempt to put the various approaches into perspective.