Background: The impact of a total laryngectomy on an individual's life has primarily been measured from a male viewpoint reflecting the demographics of a diagnosis of laryngeal cancer. A small number of studies have looked specifically at females, but very few are comparison studies. Consequently, there is little consistent research regarding any potential gender differences. Aims: To investigate whether there are gender differences in perceptions of health-related quality of life and functional abilities following total laryngectomy. Methods & Procedures: A total of 43 participants (22 males, 21 females), who had undergone a total laryngectomy procedure at least one year previously, took part in the study. They completed The European Organisation for Research and Treatment of Cancer Core Questionnaire Version 3.0 (EORTC QLQ-C30) in conjunction with the disease-specific Head & Neck Cancer Module (QLQ-H&N35). Outcomes & Results: There were no significant differences between males and females on demographic and disease-related variables, except for the following: significantly more females lived alone and changed their employment status following surgery. Males had a significantly higher global health status/quality of life than females (p less than 0.05) and significantly higher levels of physical (p = 0.01), emotional (p less than 0.01), cognitive (p less than 0.05) and social functioning (p less than 0.05). After adjusting for differences in living arrangements and change in employment status, differences in emotional and social functioning remained significant. There was a general trend for females to have higher symptom/impairment levels and to report more treatment-related problems, but the majority of these differences were not significant. Conclusions & Implications: Following total laryngectomy, females appear to be worsely affected in aspects of quality of life than males. Emotional and social functioning are particularly vulnerable. The findings imply that rehabilitation programmes after total laryngectomy need to evaluate quality of life and address these specific areas in order to improve patient-reported long-term outcomes. (Contains 4 tables and 1 figure.)