A tracheoesophageal voice prosthesis is highly effective in promoting good speech after total laryngectomy. However, long-term use of this device occasionally results in the development of fistulas that must be closed, usually at the request of the patient, because of leakage of saliva and food around the prosthesis. This report describes a technique for simple 3-layer closure of the tracheoesophageal puncture site; other procedures are discussed in light of the current literature.