The cause of subglottic stenosis (SGS) is unknown for a subgroup of patients in which there is a female predominance. Seven women ranging in age from 39 to 66 years developed symptomatic and progressive SGS. Six of the 7 patients failed to respond to all measures of conservative and radical surgical intervention. After recent thorough evaluation for gastroesophageal reflux disease (GERD) followed by medical management for such, these 6 patients have stabilized and have responded to surgical management. The seventh patient recently presented with SGS, was evaluated and treated for GERD, and has not required any surgical management. This study suggests that GERD laryngitis may be pertinent in the development of SGS. Medical management of GERD thus appears vital to successful treatment of idiopathic SGS.