Objective Gross tumor volume (GTV) has been proposed as a complementary prognostic marker, but its clinical relevance remains uncertain. This systematic review and meta-analysis evaluated the prognostic value of pretreatment GTV in laryngeal squamous cell carcinoma. Methods MEDLINE, Embase, and Scopus databases were systematically searched in accordance with PRISMA guidelines. Studies reporting pretreatment GTV and survival outcomes in laryngeal cancer were included. Primary outcome was overall survival (OS) and secondary outcome was disease-free survival (DFS). Hazard ratios (HRs) were pooled using random-effects meta-analysis. Risk of bias was assessed using the QUIPS tool, and certainty of evidence was evaluated using GRADE for prognostic studies. Results Eight retrospective studies including 1,246 patients met inclusion criteria. Patients were treated with curative-intent radiotherapy alone, radiotherapy with concurrent chemotherapy, or primary surgery with or without adjuvant radiotherapy or chemoradiotherapy. Six studies were eligible for quantitative synthesis for OS and three for DFS. Increasing GTV was significantly associated with worse OS (pooled HR per 1 cm³ increase: 1.03; 95% CI: 1.02–1.05). A similar association was observed for DFS. Overall risk of bias was judged moderate. Conclusion Higher GTV is independently associated with poorer survival in laryngeal cancer and provides prognostic information beyond TNM staging. These findings support GTV as a complementary quantitative marker for risk stratification, although prospective validation and standardized volumetric methods are required.