Background: Early-stage (T1/T2) laryngeal cancers are often treated with primary radiation. Studies of other cancers suggest diminished treatment effects and increased side effects with hardware in radiated fields. This study investigates the relationship between cervical hardware and laryngeal cancer radiation outcomes. Methods: Retrospective chart review of 245 T1/T2 laryngeal cancer patients treated with radiation. Results: Cervical hardware patients (n = 16) and non-hardware patients (n = 229) had similar demographics. Major complications including osteoradionecrosis (0% vs 2%, p > 0.99) and second primary cancers (13% vs 9%, p=0.64) were comparable. Dysphagia requiring dilation (31% vs 21%, p=0.34) and gastrostomy tube dependence (47% vs 35%, p=0.34) were higher in the hardware group but numbers did not achieve significance. Conclusions: Demographics and outcomes were similar between groups. While a trend toward worse swallowing function was noted in the hardware group, it did not reach statistical significance, possibly due to small sample size.