Laryngeal metastases are a rare complication of malignancy, mainly originating from cutaneous melanoma and renal carcinoma. Although colorectal is the third commonest cancer worldwide, just 13 cases of laryngeal metastases from colorectal carcinomas have been published since 1988. We present a novel case of an 83-year-old with airway obstruction from rectal adenocarcinoma metastatic to the subglottis, requiring awake tracheostomy. The patient’s metastatic colorectal adenocarcinoma was diagnosed in 2015 and managed with hemicolectomy and adjuvant chemoradiation. Despite treatment completion in May 2024, he presented to ED in September with dyspnoea, dysphonia and globus. Nasendoscopy revealed a critically occlusive sub-glottic mass and CT demonstrated an 11x14x18mm lesion arising from the posterior cricoid cartilage with near-complete loss of airway. Previous PET staging had also shown an enlarging subglottic lesion, but ENT referral was unfortunately missed. To mitigate airway risk, he underwent an awake tracheostomy formation, followed by microlaryngoscopy and biopsy. Pathology features were consistent with metastatic colorectal adenocarcinoma. MDM discussion favoured palliative radiation rather than surgical debulking. His tracheostomy remains in-situ with phonation and swallow preservation post-radiation. Metastases from distant malignancies account for <1% of laryngeal tumours and are rarely described in the literature. This case highlights the need for clinician cognisance of patient history, particularly as colorectal cancer incidence increases in young patients. Prompt ENT referral can prevent significant morbidities such as malnutrition, deconditioning and tracheostomy and even death from acute airway loss.