Vocal fold masses are often complex in nature and can have a devastating result on the professional voice. These lesions are usually multifactorial with synergistic contributions over time from voice use demands and technique, medical conditions, medications, and the environment. General categories of benign vocal fold masses in professional voice include nodules, polyps, and cysts, but other pathology should be considered, such as reactive lesions, intracordal scarring, feeding varices, and reparative granuloma. A perspective on these issues is essential for proper diagnosis and management. Video procedures for nodule and polyp surgery accompany this content online.