Background and Objectives: Since intractable aspiration in patients with impaired protective function of the larynx often results in multiple episode of aspiration pneumonia, repeated hospitalizations and expensive nursing care. The authors reported the preliminary results of laryngotracheal separation(LTS) in patient with chronic intractable aspiration. The purpose of this study was to report the follow up results of patient outcome with the LTS. Materials and Methods: A retrospective review of 15 patients who underwent LTS between 1996 and 2006 was conducted. Ages ranged from 3 to 72 years. Results: Eight patients had morbid aspiration as a consequence of acquired neurologic injuries and seven patients with congenital neurologic injuries. Two patients had a postoperative fistula, which was well controlled with local wound care. Following LTS, aspiration was effectively controlled in all patients and eight were able to tolerate a regular diet. Conclusion: LTS is a low-risk, successful, definitive procedure which decreases the potential for aspiration, pulmonary complications, duration of hospitalizations and increases quality of life, especially in patent with irreversible upper airway dysfunction and poor speech potential.