Macroscopic and histopathological studies were done of 30 cases of supraglottic carcinoma obtained by total laryngectomy. Similarities and differences between macroscopic and histopathological studies were investigated to identify more precisely the indications for conservative surgery. The results were as follows: 1) There was a standard similarity and considerable relationship between macroscopic and histopathological studies. 2) After macroscopic study, 26 of the 30 cases could be considered as candidates for conservative surgery, but after the histopathological study, only 20 of the 30 could be so treated. The problems between macroscopic and histopathological studies were as follows: a) To infer the invasion on thyroid cartilage, when cancer extended to the anterior commissure. b) To infer the invasion on the thyroarytenoid muscle or arytenoid region, when the vocal fold movement was inhibdited or fixed and to judge the conservation of vocal folds.