Carcinosarcomas are unusual neoplasms which are histologically biphasic, having both squamous cell carcinomas and an apparently malignant spindle cells or sarcomatous elements. Controversy as to the histogenesis of these tumors have resulted in diverse terminology to describe including sarcomatoid carcinomas, pseudosarcomas, carcinosarcomas and spindle cell carcinomas. The clinical course and natural history of these tumors are also controversial ; superficial tumors have a good prognosis, whereas invasive tumors have a prognosis worse than all squamous cell carcinomas of similar sites. In this report, we encounterd a case of carcinosarcoma originating from the pyriform sinus in a 47 year old male patient who complained dyspnea. The patient was managed with neoadjuvant chemotherapy followed by total laryngopharyngectomy, bilateral neck dissection and gastric pull-up. A review of literature concerning carcinosarcomas is discussed.