Speech rehabilitation postpharyngolaryngoesophagectomy has not received significant emphasis. We describe our experience with five patients who underwent a delayed tracheogastric puncture (TGP) after pharyngogastric anastomosis. When compared to patients who had undergone tracheoesophageal puncture (TEP) after laryngectomy, speech intelligibility and fluency were adequate for conversational speech, but voice quality was characterized by lower pitch, reduced intensity, slower rate, and a "wet" quality. There were no complications related to the TGP. TGP is a safe and often useful procedure for voice and speech restoration in patients who have undergone total pharyngolaryngoesophagectomy and pharyngogastric anastomosis.