To construct and evaluate an esophageal speech rehabilitation program for laryngeal cancer patients following total laryngectomy.The initial draft of an esophageal speech rehabilitation program for postoperative total laryngectomy patients was developed by a multidisciplinary team using Behavior Change Wheel theory and a comprehensive literature review. Following this, an expert panel reviewed and revised the program to finalize the draft. Seventy total laryngectomy patients who attended the nursing outpatient clinic of a tertiary hospital in Beijing from February 2023 to September 2023 were selected as the study subjects through open online recruitment and were divided into 35 cases in an experimental group and 35 cases in a control group using a randomized numerical table. The experimental group received the esophageal speech rehabilitation program in addition to conventional nursing care, while the control group received only conventional nursing care. Outcomes, including speech rehabilitation training status, Multidimensional Voice Program success, and quality of life, were assessed at baseline, 1 month, 6 months, and 12 months postintervention for both groups.At 1, 6, and 12 months postintervention, patients in the intervention group showed significant improvements in speech rehabilitation, voice quality, and quality of life (P < 0.0001).The esophageal language rehabilitation program for postoperative patients after total laryngectomy constructed in this study can improve patients' voice rehabilitation and quality of life and may provide a reference for clinical care.Copyright © 2025 The Voice Foundation. Published by Elsevier Inc. All rights reserved.