BACKGROUND: Few studies have been published on the cognitive function and its relationship with quality of life (QoL) in patients with laryngeal squamous cell carcinoma (LSCC) undergoing surgery. OBJECTIVE: This study aimed to assess the association between changes in cognitive function perioperatively with QoL among patients with LSCC. METHODS: This was a prospective study. Eighty-eight cases with LSCC treated with radical surgery were assessed using the Montreal Cognitive Assessment (MoCA), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and EORTC QLQ-C30. Statistical analysis was performed using SPSS 21.0 software. RESULTS: The MoCA scores were 24.78 ± 2.42 before surgery and 23.02 ± 3.06 after surgery (p <
0.001). Correspondingly, 39 patients (44.32%) had cognitive impairment before surgery, and 47 patients (53.41%) had cognitive impairment after surgery. Age (p = 0.003) and preoperative anxiety (p = 0.016) were independent factors related to preoperative cognitive dysfunction, while age (p = 0.023), postoperative anxiety (p = 0.041), operation mode (p = 0.05, p = 0.016 respectively) and preoperative MoCA score (p = 0.008) were associated with postoperative cognitive dysfunction. Patients with cognitive impairment postoperatively had poorer QOL in the score of the overall health function scale (p = 0.030). CONCLUSION: LSCC patients exhibit a high prevalence of cognitive dysfunction, which significantly associated with reduced overall QoL. Age, postoperative anxiety, operation mode, and preoperative MoCA score were significantly associated with postoperative cognitive dysfunction.