Between 1980 and 1993, 45 patients with bilateral cord abductor paralysis were treated by carbon dioxide endoscopic laser arytenoidectomy. Thyroid surgery was the main cause of bilateral laryngeal palsy (67%). Seven patients, who were tracheotomised before treatment, were decanulated. Ninety-one percent of the patients recovered physiologic respiration. The follow up period lasted from one month to thirteen one-half years. Advantages and disadvantages of laser arytenoidectomy are compared with other techniques.