Abstract: Objective To evaluate the survival rate and quality of life after primary management of laryngeal cancer by chemoradiotherapy or surgery. Methods We searched the MEDLINE, Cochrane Library, CBMdisc and some Chinese journals. Controlled clinical trials meeting the selection criteria were eligible. Meta-analysis was done using the Cochrane collaboration’s RevMan 4.3. Results Ten controlled clinical trials were included. According to the meta-analysis, there were no statistical differences in survival rate between chemoradiotherapy group and surgery groupOR=0.87, 95%CI （0.72,1.06）, P=0.06. Larynx preservation treated by chemoradiotherapy was significantly higher than surgery groupOR=0.23, 95%CI （0.12,0.44）, P=0.006. Conclusions Primary chemoradiatiotherapy achieved equivalent Results of survival rate, higher larynx preservation, and probably higher quality of life as compared to surgery. Treatment option was chemoradiotherapy with surgery for salvage of radiotherapeutic failure.