Pharyngocutaneous fistula is one of the most common wound complications after total laryngectomy. The leakage of saliva may cause an erosion of greater vessels nearby and result in a life-threatening bleeding. 65-year-old male received laryngectomy and pharyngectomy followed by Latissimus dorsi flap reconstruction due to recurred laryngeal cancer with oropharyngeal extension after postoperative radiotherapy. Pharyngeal fistula was developed and an excessive fresh blood flowed through the oral and nasal cavity. The patient was transferred to the operating room immediately, and the causing artery was ligated. The rupture of the common carotid artery and its branches should be warned when the pharyngocutaneous fistula is developed. Prompt and proper therapy must be performed for the patients with impending or acute hemorrhage.