Salvage operations (including reconstruction) should be done much more cautiously after chemoradiotherapy than primary operations because postoperative complications often occur. We report one case that had recurrences following definitive organ-preserving therapy for laryngeal cancer using a nasolabial flap to close the pharyngocutaneous fistula caused by total laryngectomy. Selected chemoradiotherapy after induction chemotherapy for radical modality was initially effective, but a salvage operation was unavoidable due to regional recurrence and one lung metastasis after 8 months. Subsequent total laryngectomy and VATS (video-assisted thoracic surgery) resulted in a pharyngocutaneous fistula in his right side. It was thought that the use of a hinged flap and other nearby flaps would be difficult because this region had received radiation (total 70 Gy). To close this fistula, we selected a nasolabial flap with buccal mucosa on his left side, which was more distant and unexposed to radiation. Although congestion of the nasolabial flap was found, we avoided further complications by exsanguination and the therapeutic use of medical leeches. A nasolabial flap is useful for pharyngocutaneous fistula closure after chemoradiotherapy, and is worth considering in addition to deltopectoral and pectoralis major flaps.