Objectives: The aim of this research was to analyze risk factors for the development of hypertonicity (spasm) of the pharyngoesophageal segment in patients undergoing total laryngectomy. Subjects and methods: A retrospective study was conducted at the Department of Ear, Nose and Throat with Head and Neck Surgery at University Hospital of Split. Data from the medical records of patients treated with total laryngectomy for squamous cell laryngeal carcinoma in the period from January 1, 2020 to December 31, 2023 were processed. The patients were divided into two groups: a group with hypertonicity (5 patients) and a group without hypertonicity (24 patients). 20 variables were analyzed, divided into the following groups: demographic data (age, gender), data from medical history (comorbidities, chronic pharmacotherapy, other malignant diseases), data related to lifestyle (cigarette smoking, alcohol consumption), symptoms at the time of diagnosis, pathohistological findings, treatment modality (type of surgery, adjuvant radiotherapy). Results: In the examined group, all patients with developed hypertonicity of the pharyngoesophageal segment were male. The average age at diagnosis of hypertonicity was 69.2 years. 60% of patients with hypertonicity also had a history of another malignant disease, but a negative family history of malignant neoplasm. In the pathohistological findings, lymphovascular invasion (LVI) was more often present in patients with hypertonicity (80%) compared to control groups (47% and 28.5%). A statistically significant difference was shown in the frequency of active smoking of tobacco products in the group with hypertonicity (60%), compared to the control group without hypertonicity with cricopharyngeal myotomy (5%) (P=0.01). Exposure to adjuvant radiotherapy, as well as the type of surgery, did not prove to be significant in increasing the risk of developing hypertonicity of the pharyngoesophageal segment (adjuvant radiotherapy P=0.62 and P=0.84; type of surgery P=0.64 and P=0.12). Conclusion: Gender and age distribution of hypertonicity of the pharyngoesophageal segment correlates with data from global literature. Active cigarette smoking could increase the risk of developing hypertonicity. Additional research is needed in order to determine with certainty the risk factors and the influence of the consumption of tobacco products, radiotherapy and the type of surgery on the occurrence of hypertonicity of the pharyngoesophageal segment.