Objectives:Salvage total laryngectomy has traditionally been performed via an open approach with extensive cervical dissection and routine microvascular free flap reconstruction. Transoral robotic total laryngectomy(TORS-TL) represents a minimally invasive alternative that may challenge established reconstructive paradigms while maintaining oncologic integrity. We aimed to compare perioperative, oncologic, and functional outcomes between TORS-TL and open salvage laryngectomy with free flap reconstruction. Methods: A retrospective cohort study was conducted comparing eight patients undergoing TORS-TL to eight patients undergoing open salvage laryngectomy with free flap reconstruction. Demographic and functional outcomes were analyzed. Statistical comparisons were performed using Wilcoxon rank-sum and Fisher’s exact tests. Results:TORS-TL was associated with significantly shorter inpatient length of stay compared to open laryngectomy with free flap reconstruction(p = 0.013). There were no significant differences in surgical margin status, readmission rates, return to the operating room, or neopharyngeal leak rates. Limited variability precluded statistical comparison of lymphedema and shoulder dysfunction. Patients undergoing TORS-TL demonstrated early and reliable return to oral intake, with feasibility for secondary tracheoesophageal puncture placement. Functional quality-of-life outcomes were comparable between groups. Conclusions:TORS-TL is a feasible and oncologically sound alternative for select salvage laryngectomy patients. Avoidance of free flap reconstruction and extensive cervical dissection may reduce perioperative morbidity without increasing major wound complications. In appropriately selected patients, reconstructive requirements following salvage laryngectomy may be less extensive than historically assumed. Larger prospective studies with longer follow-up are necessary to validate oncologic equivalence and further define patient selection criteria.