Twenty-six speech and language therapy (SLT) clinical files, in which patients presented with a medical diagnosis of bilateral or unilateral vocal fold nodule(s), were audited retrospectively over a six year period (1992-1998). The objective of the study was to evaluate current practice within our trust in the management of patients with vocal fold nodules against what was considered 'best practice' and to take action for improvements where deficits were identified. Multidimensional outcome measurements were employed. This study lends support to experimental findings of treatment effectiveness. Results demonstrated elimination and/or reduction of vocal fold nodules in over 70% of clinical files audited. Post-therapy over 80% of patients presented with either a normal voice quality or a mild degree of dysphonia.