Mucoepidermoid carcinoma of the larynx is an uncommon malignancy. Nearly all cases are found in middle-aged and elderly men. Most cases arise in the supraglottis. Mucoepidermoid carcinoma is classified histologically as low grade and high grade. The prognosis is relatively good for low-grade tumor and poor for high-grade mucoepidermoid carcinoma, which is also referred to as adenosquamous carcinoma. The treatment is primarily surgical, although the efficacy of post-operative radiation, with and without chemotherapy, is presently under evaluation in a National Intergroup Study. The case reported here is nearly classic for high-grade mucoepidermoid carcinoma, both as to clinical presentation and morphology. This report and discussion are offered to familiarize the reader with this uncommon lesion, of which fewer than 80 cases have been reported.