Aims: To compare the survival outcomes of total laryngectomy and chemoradiation for transglottic laryngeal carcinoma, and to examine the pathological characteristics of transglottic disease in an Australian cohort. Methodology: A retrospective cohort study was conducted on patients who underwent either total laryngectomy or curative radiation/chemoradiation for transglottic laryngeal carcinoma at a single tertiary hospital in Sydney, Australia. Baseline characteristics and clinical outcome data were extracted from general and oncological databases. Pathological data of all total laryngectomy patients were gathered from their respective anatomical pathology services. Results: Thirty-two patients with transglottic laryngeal carcinoma were enrolled, with a mean age of 67.3±11.8 years. 41.9% of patients had T4 disease and 20.0% were nodal positive. 71.9% (n=23) of transglottic tumours underwent total laryngectomy as the primary treatment, with the remaining 28.1% (n=9) undergoing non-surgical curative radiation/chemoradiation. Total laryngectomy patients had significantly better 5-year disease-free survival (53.8% vs 0%, p=0.016), but equivalent 5-year disease-related mortality (22.2% vs 20.0%, p=0.920), all-cause mortality (46.2% vs 85.7%, p=0.085), incidence of locoregional recurrence (0.0% vs 14.3%, p=0.162) and metastatic disease (15.4% vs 14.3%, p=0.944). The most commonly involved lymph node levels were level II (50%), level III (40%) and level IV (30%). 70% of pathological nodes demonstrated extracapsular spread. The prevalence of cartilage invasion in transglottic disease was 69.6%. Conclusion: In this Australian cohort, total laryngectomy yielded better 5-year disease-free survival compared to chemoradiation for transglottic laryngeal cancers. Transglottic cancers demonstrated high rates of cartilage invasion and extracapsular spread, most commonly involving nodal levels II and III.