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Office-based laryngeal laser surgery was created recently and is emerging as a reliable and practical method of treating a number of laryngeal lesions. This style of minimally invasive surgery is becoming increasingly popular in the United States and abroad.Fiber-based lasers and distal-chip flexible endoscopy have facilitated a new style of surgery. Epithelial diseases such as dysplasia and papillomatosis are well suited for treatment. Although the initial angiolytic laser used was a 585-nm pulsed-dye laser, the 532-nm pulsed-potassium–titanyl–phosphate laser has been demonstrated to be more effective. The 2013-nm Thulium laser shows promise as an office-based laser that simulates the properties of the carbon dioxide laser.Evolving technologies to enhance laryngoscopic imaging and lasers along with socioeconomic forces should lead to increasing numbers of laryngeal procedures being performed in the office with local anesthesia.