The treatment of the advanced carcinoma involving larynx, hypopharynx and cervical esophagus requires radical operation and postoperative radiation therapy. An extended total laryngectomy with ablation of the hypopharynx and cervical esophagus requires reconstruction of the food passageway. Wookey flap and deltopectoral flap had been previously used for that purpose, but since the pectoralis major myocutaneous flap was introduced, those techniques were rarely used. Recently, gastric transposition or free microvascular bowel transfer are also recommended. Nine cases of esophageal reconstruction using the pectoralis major myocutaneous flap during last 25 months were analyzed according to the mode of reconstruction, postoperative complications, morbidity and the time sequence of recovery. The following results were obtained; 1) The modes of esophageal reconstruction with pectoralis major myocutaneous flap were one Janus flap, three tubular reconstruction and five anterior wall reconstruction. 2) The donor site of pectoralis major myocutaneous flap could be closed by primary suture, but in one case, a skin graft was required. 3) There was one case of total flap necrosis. 4) The average completion time to oral feeding in 8 cases with pectoralis major myocutaneous tubulation was 34.5 days. 5) Fistulas were noticed in 6 cases in two-week-esophagogram but all were sucessfully managed within 2 months. 6) In spite of succesful reconstruction, 2 patients with hypopharyngeal cancer died of recurrence. 7) Delayed dyphagia was noted in 2 out of 8 survived cases.