Salvage laryngectomy for recurrent laryngeal carcinoma following failed radiotherapy or chemoradiotherapy is associated with high postoperative complication rate. The primary aim of this paper was to assess whether use of muscle myocutaneous flap (PMMCF) as an interposition graft reduces the postoperative pharyngocutaenoues fistula rate. It is a multicentre retrospective study. It compares two group of patients undergoing salvage laryngectomy. One group with use of pectoralis muscle flap as an interposition graft and another without the use of pectoralis muscle flap. The primary endpoint of PCF occurred in 15 of the 59 patients (25.4%). PCFs occurred in 13 of the 37 patients in the non-PMMCF group (35.1%) and two of the 22 patients in the PMMCF group (9.1%). The study concludes that routine use of pectoralis muscle myocutaneous flap (PMMCF) does reduce the postoperative pharyngocuteanoeus fistula rate.