Total glossectomy is recommended as the primary treatment modality for large tumors involving the mobile portion or base of the tongue. If the larynx is totally preserved, serious sequelae such as aspiration pneumonia and dysphagia can be developed. With concomitant laryngectomy, adequate phonation is hampered. Total glossectomy with laryngeal preservation in properly selected patients can provides local and regional control with preservation of speech and deglutition for promoting quality of life. We experienced a 68-year-old female patient who received total glossctomy with laryngoplasty due to adenoid cystic carcinoma of base of the tongue. Total glossectomy was performed via mandible swing with bilateral selective neck dissection at level I to IV and supraglottic laryngoplasty was done in order to preserve the laryngeal function. To repair oral defect and reconstruct the tongue, sensate radial forearm free flap was used by microvascular anastomosis. A cricopharyngeal myotomy and hyoid suspension were performed to facilitate swallowing and reduce aspiration.