We summarized the perioperative care experience of a patient with simultaneous hypopharyngeal- esophageal multiple primary carcinoma with third-degree laryngeal obstruction. Aiming at the patient’s high risk of airway obstruction，rapid disease progression，pulmonary infection，poor general nutritional status，and weakened motor function，measures such as early warning and emergency management of airway obstruction risk，phased implementation of lung protective strategies，goal-oriented preoperative prehabilitation nutritional management，and low load and small intensity individualized antiobstruction exercises were taken to improve weakness and promote patient recovery. After 34 d of active treatment and care，the patient was discharged in a stable condition，and the patient was in good condition at 1-month follow-up after discharge.