OBJECTIVE To determine whether, in a developing world context, early oral feeding after laryngectomy is safe, cost-effective and appropriate. METHODS A prospective study of early oral feeding after laryngectomy, compared with retrospective, historical delayed feeding controls. METHODS Forty patients underwent total laryngectomy for advanced carcinoma of the larynx with or without hypopharyngeal involvement, not requiring tongue base resection or myocutaneous flaps, and were commenced on oral feeding on the second post-operative day. Thirty-nine laryngectomy patients previously managed in the same unit who had received conventional, delayed oral feeding served as controls. RESULTS Pharyngocutaneous fistulae developed in 20 per cent of the early feeding patients, compared with 15.4 per cent of the delayed oral feeding controls (p = 0.592). For patients who did not develop fistulae, hospitalisation was shorter in the early oral feeding group (p = 0.007). CONCLUSIONS Early oral feeding for laryngectomy patients is recommended, both in developed and developing countries.