The decision to treat patients suffering from glottic cancer with either radiotherapy or surgery is both complex and controversial. Transoral laser microsurgery is a surgical technique that offers an attractive alternative therapy for laryngeal cancer. In addition to excellent oncologic outcomes and organ preservation, the benefits of transoral laser microsurgery include low morbidity and mortality, shorter periods of hospitalization and exceptional functional results. As the evidence base for the effectiveness of laser surgery grows, transoral laser microsurgery has become established as a valid surgical option for the treatment of early laryngeal cancer. In this article we examine the surgical technique and discuss the oncologic and functional outcomes of transoral laser microsurgery. Furthermore, we offer a vision of the future of endoscopic laser surgery for the management of cancer of the larynx and the upper aerodigestive tract.