We present a case of OPCA with severe respiratory failure due to vocal cord dyskinesia. This vocal cord dyskinesia was found by fiberoptic bronchoscopy and confirmed by laryngeal electromyogram. Tracheal fenestration and drug therapy of haloperidol were successful for clinical improvement. To our knowledge, this is the first report of vocal cord dyskinesia in OPCA. We emphasized that OPCA could complicate vocal cord dyskinesia, causing severe respiratory failure.