Objective To explore relative factors affecting dysphonia of the Blom-Singer pronunciation tube. Methods The clinical data of 108 patients who had undergone Blom-Singer voice producing reconstruction following total laryngectomy were retrospectively analyzed. 96 cases received stage Ⅰ Blom-Singer voice producing reconstruction, and the other 12 cases underwent stage Ⅱ Blom-Singer voice producing reconstruction. Results 22 of 96 cases who had undergone stage Ⅰ Blom-Singer voice producing reconstruction had less effective phonation(22/96, 23%), and 8 of 12 cases who had undergone stage Ⅱ Blom-Singer voice producing reconstruction did not get the expected voice(8/12, 67%), and the total failure rate of the two operative methods was 28%. Conclusion The successful rate of stage Ⅰ Blom-Singer voice producing reconstruction was higher than that of the stage Ⅱ Blom-Singer voice producing reconstruction. Effect of voicing quality after the operations was closely related to following factors, such as treatments to the cricopharyngeal muscle, integrity of the tracheoesophagus wall, size of the trachea stoma, pharyngeal fistula, stenosis of the esophagus hypo-pharyngeal cavity and pulmonary function of patients.