Handsfree tracheoesophageal speech contributes to a more natural way of speaking after total laryngectomy. Instead of using a finger for manual occlusion, the valve closes automatically on exhalation and allows air from the lungs to pass through the voice prosthesis into the esophagus where the voice sound is originated. Since the patient does not need the use of one hand for speaking anymore with an automatic speaking valve, the handicap is less noticeable to others, speech appears to be more natural and both hands are free during speaking. Unfortunately, not all laryngectomized patients are able to achieve handsfree speech due to several reasons. The Provox FreeHands HME has some specific features (see animation on the Cd-rom) that might be helpful in increasing the percentage of patients that is able to use handsfree speech. This chapter will address all issues that should be considered when fitting a Provox FreeHands HME in order to achieve optimal results for handsfree speech.