Our previous comparative study of CT and MRI in laryngeal cancer has proven that MRI is more useful than CT in evaluating catilage involvement. Although MR imaging is more sensitive than CT in detecting cartilage invasion, there is clearly a limitation of detectable cartilage invasion due to respiratory motion artifact and blood flow-related artifact in MR images. In this study we performed MR examination in eight patients with laryngeal carcinoma prior to total laryngectomy and again in the pathologic specimens obtained from laryngectomy. Whole-mount sections of the laryngeal specimen in the horizontal plane were compared with the corresponding levels of preoperative and specimen MRI in axial plane. We evaluated the accuracy of preoperative MRI and specimen MRI in diagnosing involvement of cartilages or laryngeal spaces. The results of our study were as follows. 1) The diagnostic accuracy in cartilage involvement were 84.4% and 87.5% in preoperative MRI and specimen MRI, respectively. 2) As to the laryngeal space involvement , diagnostic accuracy of MRI was 96.8% and there was no difference in accuracy rates between preoperative MRI and specimen MRI. Therefore we concluded MR is onr of the choice of imaging study for the evaluation of laryngeal cancer in spite of its limitations in detecting cartilage involvement even though the motion or blood flow-related artifacts are excluded.