Considering clinical evidence,<2% of laryngeal malignancies are distant metastases. Cutaneous melanomas are the preponderant primaries metastasizing to the larynx, followed by renal cell carcinomas, breast and lung carcinomas. Colonic adenocarcinoma metastases to the larynx are extremely rare: only 13 cases have been described since 1972. We present the first case of sigmoid colon adenocarcinoma metastasis to the larynx in a patient who developed peristomal malignancy recurrence after total laryngectomy. Patients with metastasis of colonic adenocarcinoma to the larynx usually present with disseminated disease: in view of the poor chances of long-term survival of these patients conservative palliative laryngeal treatments should be carried out to improve the quality of life. Curative treatment should be considered only in isolated laryngeal metastasis.