Most patients with bilateral vocal cord paralysis have a fairly satisfactory voice, but their airway is usually compromized. The management of such patients presents a challenge to the otolaryngologist. Numerous surgical procedures have been developed in an attempt to improve the patient's airway insufficiency without leaving him with a breathy, weak voice. Arytenoidectomy is currently the most accepted, quickest, and most reliable method of dealing with the problem without long term tracheotomy. Among these methods, CO₂ laser arytenoidectomy is more desirable since it requires no incision, and it has many other advatages : precision, good hemostasis, more easier procedure, decreased post-op edema, scarring, good operating fields. Ten patients with bilateral vocal cord paralysis have been treated by endoscopic laser arytenoidectomy by the authors : 8 of 10 patients have successfully decannulated or corked. Remaining two cases were failed : one is due to granuloma in the interarytenoid region, and the other is due to severe laryngotracheal stenosis.