Background Laryngeal carcinoma (LC) remains a significant economic and emotional problem to the healthcare system and severe social morbidity. New tools as Machine Learning could allow clinicians to develop accurate and reproducible treatments. Methods This study aims to evaluate the performance of a ML‐algorithm in predicting 1‐ and 3‐year overall survival (OS) in a cohort of patients surgical treated for LC. Moreover, the impact of different adverse features on prognosis will be investigated. Data was collected on oncological FU of 132 patients. A retrospective review was performed to create a dataset of 23 variables for each patient. Results The decision‐tree algorithm is highly effective in predicting the prognosis, with a 95% accuracy in predicting the 1‐year survival and 82.5% in 3‐year survival; The measured AUC area is 0.886 at 1‐year Test and 0.871 at 3‐years Test. The measured AUC area is 0.917 at 1‐year Training set and 0.964 at 3‐years Training set. Factors that affected 1yOS are: LNR, type of surgery, and subsite. The most significant variables at 3yOS are: number of metastasis, perineural invasion and Grading. Conclusions The integration of ML in medical practices could revolutionize our approach on cancer pathology.