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Reports on the management of chainsaw penetrating laryngotracheal injuries are limited. These injuries can be catastrophic because of possible injury to the carotid and vertebral arteries or neural and aerodigestive tract injury. A systemic and multidisciplinary approach is necessary when faced with this type injury. We present a 59-year-old carpenter with an accidental, and self-inflicted, chainsaw injury that afflicted anterior neck, larynx and posterior wall of pharynx.