Small cell neuroendocrine carcinomas of the larynx are uncommon neoplasms. Differential diagnosis includes a limited variety of tumors such as typical carcinoid and atypical carcinoid tumors of the larynx and metastatic small cell lung carcinomas. In this study, 4 cases of laryngeal small cell carcinoma of neuroendocrine type were studied for morphological and immunohistochemical features. Three primary laryngeal small cell carcinomas, as well as one metastatic small cell lung carcinoma were detected to be immunopositive for TTF-1. Considering literature data and our findings, the value of TTF-1 expression was found to be questionable in the differential diagnosis between primary and metastatic small cell carcinomas of the larynx.