There are very few reported cases of laryngeal squamous cell carcinoma (SCC) in patients with a background of human immunodeficiency virus (HIV) infection. We report a case of a 42-year-old man who developed a T2 N0 left vocal cord well differentiated SCC with an 11 year history of HIV infection. He successfully completed a course of radical radiotherapy 66 Gy in 33 fractions over 47 days. During his treatment he experienced only a grade 1 Radiation Therapy Oncology Group (RTOG) acute toxicity reaction to the larynx and no weight loss. At 32 months follow up he remains disease free and has no significant late morbidity. Prior to his radiotherapy his CD4 count was 350 cells mm(-3); we discuss the view that the treatment chosen needs to be individually tailored with respect to the patient's immune status.