Objective To explore the location, treatment outcome, and survival of multiple primary cancer(MPC) patients with laryngeal carcinoma as the initial lesion, so as to improve the diagnosis and treatment of these patients. Methods Totally the clinical data of 42 MPC patients with laryngeal carcinoma as the initial lesion were retrospectively analyzed. The factors influencing the clinical outcomes were discussed and the diagnosis and treatment experience was summarized. Results Twenty-two cases (52.4%) had MPCs in the head and neck regions and 20 (47.6%) in the remote organs. The total 3- and 5-year survival rates were 47.6% and 26.2%, respectively. For patients receiving active therapies, the 3- and 5-year survival rates were 56.3% and 34.4%, respectively, which were significantly higher than for those receiving no therapies (20.0% and 0, P<0.01). The total 3- and 5-year survival rates were not significantly different between the MPCs in the head and neck regions and in the remote organs (P>0.05). The incidence of head and neck MPCs in patients receiving radiotherapy was 77.3%, which was significantly higher than that of the patients receiving no radiotherapy(P<0.01). The treatment methods of esophageal carcinoma had no noticeable influence on the prognosis of MPC patients. Conclusion Lung carcinoma and nasopharyngeal carcinoma are the most common secondary primary cancer in laryngeal carcinoma patients with MPCs. Patients receiving radiotherapy are likely to have more MPCs in the head and neck regions; prompt treatment of secondary primary cancer can improve the survival of laryngeal carcinomas patients with MPCs.