Objective: Reconstruction of laryngotracheal stenosis continues to pose a significant challenge. Cartilage grafts have been in use for almost a century, but despite good clinical results, many questions concerning the survival and growth of implanted cartilage persist. To reduce donor site morbidity, the use of homologous cartilage has been investigated. This study compared alcohol-stored homologous auricular cartilage with autologous auricular cartilage for anterior graft laryngotracheal reconstruction in a rabbit model, Methods: Autologous and alcohol preserved homologous auricular cartilage was transplanted to the resected anterior tracheal wall of the twenty New Zealand rabbits. Rabbits were sacrificed 6 weeks after surgery and histologic analysis was performed on the implanted cartilage grafts. Results: The autografts were significantly more likely than the homografts to demonstrate Viable cells (95% vs. 30%, P < 0.05) and less likely to exhibit significant resorption, fibrosis or necrosis (P < 0.05). Resorption and necrosis were most common in areas of trauma to the graft. Complete epithelialization occurred in all of the autografts but in only 65% of the homografts (P < 0.05). New cartilage formation and integration of the implanted grafts was poor with both types of grafts. Conclusion: Autologous cartilage appears to have better survival than alcohol preserved homologous cartilage when used for anterior graft laryngotracheal reconstruction in a rabbit model. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.