Upper airway obstruction due to bilateral vocal cord paralysis was successfully relieved by carbon dioxide laser posterior cordectomy. All patients achieved satisfactory airway and decannulation. Flow-volume loop spirograms obtained preoperatively and postoperatively documented improved flow rates on inspiration and expiration. Final voice quality was subjectively good in all patients. Follow-up has ranged from 1 year 10 months to 5 years 8 months, and initial improvement has been sustained in all cases. Carbon dioxide laser posterior partial cordectomy is an alternative management option for relief of upper airway obstruction due to bilateral vocal cord paralysis. The procedure can be performed without prophylactic tracheotomy. Subjectively good voice quality is preserved.