From 2004 to December 2012, 40 cases (43 lesions) of superficial laryngopharyngeal cancer were treated with transoral videolaryngoscopic surgery (TOVS). The 5-year overall survival rate, disease-specific survival rate, and local control rate were 85%, 98%, 97% (100% including salvage treatment), respectively. For initial treatment cases (36 cases), the incidence of lymph node metastasis and endoscopic morphology were evaluated. Lymph node metastasis was not observed in epithelial cancer (n = 5) and was observed in 32% of the cases of subepithelial cancer (n = 31). Subepithelial cancer, which was initially node negative, presented delayed nodal metastasis in 8.7% of the cases. The depth of cancer invasion is associated with lymph node metastasis. Careful management for delayed nodal metastasis is recommended for cancer invading more than 1mm beneath the basement membrane level. The endoscopic type of 0-Is and 0-IIa is associated with deeper tumor infiltration and higher nodal metastasis rate. Among 0-I type lesions, sub-classification into 0-Is (sessile type) and 0-Ip (pedunculated type) is useful for differentiating the risk of lymph node metastasis.