Background: The purpose of this study was to investigate unmet supportive care needs in patients treated with total laryngectomy and its associated factors. Methods: In this cross-sectional study, 283 patients who underwent total laryngectomy completed questions on supportive care needs (Supportive Care Needs Survey [SCNS]). Median time since total laryngectomy surgery was 7 years (range 0-37 years). The prevalence of unmet supportive care needs and its associated factors were investigated using logistic regression analyses. Results: Unmet supportive care needs were highest for the head and neck cancer-specific functioning domain (53%), followed by the psychological (39%), physical and daily living (37%), health system, information, and patient support (35%), sexuality (23%), and lifestyle (5%) domains. Seventy-one percent reported at least one low, moderate, or high unmet need. Female sex, living alone, and having a voice prosthesis were positively associated with unmet needs on 1 domain (P <.05). A worse health-related quality of life was associated with unmet needs on all domains. Conclusion: The majority of patients who underwent total laryngectomy report at least one low, moderate, or high unmet supportive care need.