BACKGROUND: Following laryngectomy a common method of reconstruction for vocal function was using skin flaps for cervical esophagus with a voice prosthesis for voice restoration. However, there are many disadvantages if the prosthesis is to be used for a long time. When the patients are expected to have a long life expectancy, an alternative choice is free bowel transfer for reconstruction of both the cervical esophagus and voice tube. METHOD: From 1990 to 2003, 46 cases of free bowel transfer had been performed.Among them 27 cases were jejunal flap and 19 cases were ileocolon. The voice tubes were divided into three fashions and were evaluated. RESULTS: All patients could eat from the mouth and were able to get rid of the jejunostomy tube. The best design for voice tube included the following components:(a) rigidity of the cervical esophagus and voice tube, (b) narrow opening of the voice tube into esophagus, (c) end-to-end anastomosis between voice tube and tracheal stump. CONCLUSION: Good design is essential to voice function. The voice function of a transferred bowel can be improved to be comparable to voice prosthesis. In the mean time it lacks the complications of a voice prosthesis. For the patients of long survival this is a worthwhile option. With our suggested method the voice tube does not need to be revised for the patients in the future.