OBJECTIVE: To evaluate the treatment of a patient after total laryngectomy in the acquisition and use of esophageal speech. CASE REPORT: The research patient was male, aged 65 years, who had undergone total laryngectomy because of squalors cell carcinoma. He lived in the city of Fortaleza, Ceará (Brazil). Treatment began 2 months after the patient underwent the surgery. The sessions lasted from May 2011 to April 2012, with 2 sessions per week in private practice. The therapy was documented on video with the permission and prior written consent of the patient. The speech evaluation showed no adaptive mechanisms in communication or negative social-emotional impact on communication after laryngectomy. In the first few sessions, the patient quickly incorporated the technique of esophageal speech. After 2 months of intervention, the patient had good coordination of air injection with esophageal phonation and articulation, which allowed the production of short sentences with a single injection of air; significant improvement of speech intelligibility with every week of treatment; and substantially significant changes in the emotional and social condition of the patient, which was also reported by his family. CONCLUSION: The therapeutic progress has been rapid and notorious, indeed decisive engagement of patients and satisfactory results. An intervention needs to reflect therapy that combines an ethical and humane health care outlook that then generates significant results for the quality of life of patients.