This article discusses negative and positive predictors for acquiring esophageal speech. These indicators are grouped under two broad categories: anatomidphysiologic and psychological/ social. The success and failure rates and advantages and disadvantages of esophageal speech are also presented. Consideration of all factors will enable professionals to counsel patients realistically about their potential for successful acquisition of this method of alaryngeal speech. HEAD & NECK SURGERY 10:S105-S109,1988T h e literature is replete with clinical impressions, findings from investigative studies, and results of questionnaire surveys suggesting factors that impact negatively or positively on a laryngectomized individual's ability to acquire esophageal speech. Before professionals can counsel patients adequately about the advantages or disadvantages of this mode of communication, they must be aware of these factors and be willing to weigh them against succesdfailure rates.