Objective: To investigate the significance of type IV collagen, metalloproteinase-2 (MMP-2), metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) expression in laryngeal squamous cell carcinomas (LSCCs). Methods: Expression was quantified in 44 LSCC and 22 adjacent non-cancer normal tissues using a streptavidin-peroxidase conjugated immunohistochemistry and associations between the levels of the four proteins and clinicopathological characteristics in LSCC were analyzed. Results: Significantly different expression of all four proteins was observed in LSCC and adjacent non-cancer normal tissues (P<0.05). Expression of type IV collagen correlated with primary cancer status (P = 0.04), clinical stage (P = 0.04) and histological grade (P = 0.01). Expression of MMP-9 correlated with the location of the tumor (P = 0.04), cervical node metastasis (P = 0.02) and prognosis (P = 0.02). The (MMP-2+MMP-9)/TIMP-1 score was associated with the prognosis of LSCC (P < 0.01). Conclusions: This study suggests that expression of type IV collagen and its regulators is strongly associated with the development of LSCC. Type IV collagen and MMP-9 may be more valuable than MMP-2 and TIMP-1 for the evaluation of clinical characteristics. Regulation of type IV collagen may contribute to the balance of MMPs and TIMPs in LSCC.