Stomal recurrence has been defined as ""a diffuse infiltration of neoplastic tissue at the junction of the amputated trachea and skin"". Stomal recurrence of the laryngeal carcinoma is a dreaded complication in the management of laryngeal carcinoma and continues to result in poor suvival rates. But radical en bloc dissection of the stoma, with deep border including mediastinal lymph nodes yields the most promising chance of cure. Authors treated one case of stomal recurrence after total laryngectomy with modified radical neck disection in 49 years old male patient as mediastinal dissection. So we report this case with literature review.