AbstractObjectiveLaryngeal verrucous carcinoma (LVC) comprises 1% to 4% of all laryngeal tumors. Although controversial, surgery has been the mainstay of treatment, due to concern about anaplastic transformation with radiotherapy. We aimed to study LVC patients to identify treatment patterns for primary and recurrent diseases.Study DesignRetrospective cohort study.SettingTertiary referral center.MethodsPatients with a pathological diagnosis of LVC treated over a 28‐year period were included. Baseline demographics, and treatment outcome measures including 5‐year laryngeal preservation rates (LPR), overall survival (OS), and recurrence‐free survival (RFS) were included. A literature review of published studies within the same study period was also completed.ResultsThirty‐two patients were included in the analysis (median age 61.5 years, 93.8% [30/32] male). Twenty‐three patients had T1 disease, and 9 had T2 disease with no evidence of regional or metastatic disease. The most common presenting symptom was hoarseness (93.8%) and the majority within the glottis 81.3% (26/32). Twenty‐nine patients underwent primary surgery only (28 local excisions, 1 vertical partial laryngectomy) meanwhile 3 underwent local excision with postoperative radiotherapy. LPR, OS, and RFS at 5 years were 95.8%, 90.1%, and 80.6%, respectively. Our literature review identified 23 previous studies, mostly single‐institution retrospective case series. Our study was the largest Canadian study in the literature to date.ConclusionAll LVC patients were treated with primary surgery, consistent with the current literature with excellent 5‐year OS and LPR. There was no consensus on the treatment of recurrent disease. Future prospective multicenter studies are warranted to further study this rare disease population.