The Blom-Singer adjustable tracheostoma valve (ATV) is a new tracheostoma valve, introduced in 1992 to improve voice rehabilitation after total laryngectomy. Little research has been done to evaluate the benefits of this valve. Our study evaluates the advantages and disadvantages of using this device. Eighteen laryngectomized patients with a low-resistance Provox voice prosthesis received an ATV, using minimal selection criteria. The patients are evaluated according to a specific protocol. The effectiveness of the humidifilter, valve and fixation method and the benefits are evaluated. Approximately 66% of the 18 patients are still using the ATV. We report the differences between the current users and the dropout group. Patient factors are discussed that seem to have an impact on the effective use of the valve, such as age and mucus production. We consider the ATV to be a valuable device for fingerless speech in the laryngectomized patient.