Endoscopic debridement of obstructing laryngotracheal carcinoma with the microdebrider is an alternative to CO2 laser excision or emergency tracheotomy. This is a retrospective study of 27 patients with advanced laryngotracheal carcinoma treated with the microdebrider for airway obstruction from 1998 to 2002. In 26 patients, the carcinoma was debrided successfully and tracheotomy was safely avoided. Postoperative bleeding was encountered in 1 patient with a coagulopathy. Two of the patients later required tracheotomy during radiotherapy secondary to radiation-induced laryngeal edema. Both were safely managed without acute airway compromise. Laryngeal debridement provided up to 3 months of stable airway until definitive oncological treatment was performed. Endoscopic microdebridement of obstructing carcinoma is a relatively simple and highly accurate approach to restoring a stable airway. It provides extra time for preoperative oncological, psychological, and nutritional planning.