Background: Thyroid cartilage invasion in laryngeal carcinoma is a critical factor in staging and treatment planning. Accurate assessment using imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) is essential for determining the extent of invasion. This study aims to compare the effectiveness of CT and MRI in assessing thyroid cartilage invasion in patients with laryngeal carcinoma to provide evidence-based recommendations for clinicians. Methods: This randomized controlled trial included 50 patients diagnosed with laryngeal carcinoma, who underwent both CT and MRI to evaluate thyroid cartilage invasion. Direct laryngoscopy and histopathological data served as the gold standard for confirming the diagnosis. Demographic information, smoking status, and relevant clinical data were collected. CT scans were performed using a 64-slice multislice CT scanner, while MRI studies were conducted with a 1.5 Tesla machine. The accuracy of CT and MRI was compared using histopathological findings as a reference. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both imaging modalities. Results: CT demonstrated a sensitivity of 100.00% and a specificity of 61.54%, with a PPV of 88.10% and an NPV of 100.00%. MRI showed a sensitivity of 100.00% and a specificity of 80.00%, with a PPV of 95.12% and an NPV of 100.00%. Both CT and MRI had high sensitivity and NPV, making them reliable tools for excluding thyroid cartilage invasion. However, MRI exhibited a higher specificity and PPV compared to CT, indicating greater accuracy in confirming the presence of cartilage invasion. The chi-square test revealed no significant differences between the imaging modalities and histopathological findings (p > 0.05).