The principal function of the larynx is to protect the airway and in humans it plays a part in voice production and the Valsalva manoeuvre. In common with other mammals, the larynx lies high in the neck at birth. In humans it starts to descend within the first few months of life to eventually lie at the level of the sixth cervical vertebra. Charles Darwin noted in On the Origins of Species that homo sapiens is the only animal species whose upper aerodigestive tract fails to adequately serve its principal evolutionary functions of preventing aspiration and acting as the gateway to the lungs. 1 This adult position of the larynx allows humans to meet the requirements of complex speech through resonance and articulation, but also leaves it more exposed to external trauma. Laryngeal trauma can disrupt one or all of the functions of the larynx, and as the ‘gateway’ to the lungs, injury can be acutely life-threatening. 2–4 Laryngeal trauma often co-exists with cervical and intracranial injuries, and frequently forms part of a multiple trauma scenario. 4 It is vital, therefore, that all patients with suspected laryngeal injury be managed by a multidisciplinary trauma team. The role of the otolaryngologist is to detect and appropriately manage the acute laryngeal injury and minimise long-term sequelae. 4–6 Laryngeal trauma can be broadly divided into external trauma, which can be blunt or penetrating, and internal trauma, which can be caused by iatrogenic, thermal, caustic or foreign body injuries.