Abstract: Objective To study the incidence of pharyngeal fistula and the use of antibiotics in the patients with laryngeal cancer underwent total laryngectomy and to analyze the distribution of bacteria in the operative area of laryngectomy to provide some experimental basis for the use of antibiotics and reduce the incidence of pharyngeal fistula. Me thods A retrospective statistical analysis was conducted involving 42 cases of pharyngeal fistula occurred in 185 patients with laryngeal cancer in the First Affiliated Hospital of Kunming Medical University. Re s ults (1) Among the 185 patients with total laryngectomy, pharyngeal fistula occurred in 42 cases, and the incidence of pharyngeal fistula was 22.70%. Compared with the postoperative antibiotic use and the incidence of pharyngeal fistula (P = 0.005) , the difference was statistically significant. Compared with the use of anti-anaerobes after surgery and the incidence the difference was not statistically significant of hypo-pharyngeal fistula (P = 0.961) , 2) The airway secretions were cultured in 60 patients with laryngectomy, and the most pathogenic bacteria were gram-negative bacteria (67.24%) . Among them, pseudomonas aeruginosa (14 cases, 24.14 %) was the most. Conclus ion The bacteria of postoperative airway fistula after laryngeal cancer was mostly gram-negative, and selecting antibiotics correctly according to the distribution of pathogens in the operative area can significantly reduce the incidence of pharyngeal fistula.