An endoscopic laser arytenoidectomy was performed on 20 patients for bilateral abductor vocal cord paralysis due to various causes. Ten patients had a previous tracheostomy prior to the laser arytenoidectomy and all were subsequently decannulated. One patient without a previous tracheostomy required an immediate tracheostomy after the completion of the laser arytenoidectomy due to a severe laryngeal edema and was also subsequently decannulated. All of these patients had a satisfactory voice and an adequate laryngeal airway. The advantages of the laser for endoscopic arytenoidectomy are facility of the operation, hemostasis, minimal postoperative edema, and absence of scarring.