OBJECTIVE: To report a case of duodenal metastasis of laryngeal squamous cell carcinoma revealed by acute intestinal obstruction. CASE REPORT: A 55-year-old male was initially treated for cT4N1M0 laryngeal squamous cell carcinoma, with total laryngectomy, bilateral neck dissection, total thyroidectomy and pectoralis major flap. Subsequently, he received radiotherapy and chemotherapy. Then, he was periodically monitored, with clinical examination and cervicothoracic CT, according to guidelines. Three years later, he presented acute intestinal obstruction. Abdominal CT revealed a 35mm obstructive duodenal tumor involving the head of the pancreas. Gastroscopy enabled biopsies, which confirmed metastasis of the laryngeal carcinoma. After gastro-entero-anastomosis, a first line treatment with cisplatin, 5-fluorouracile and pembrozilumab was started. It was complicated by abdominal bleeding, which required inferior duodenopancreatic artery embolization and colic perforation requiring colectomy. Due to deterioration in general health, 2 injections of pembrozilumab alone were made. Then, because of progression, the patient received 1 second-line injection of docetaxel. He finally died of acute pancreatitis, 7 months after diagnosis. CONCLUSION: Duodenal metastasis of squamous cell carcinoma of the larynx is rare but possible. This case report highlights the importance of clinical and radiological monitoring, particularly in locally advanced tumor.