One of the fastest growing specialties in otolaryngology—head and neck surgery is the field of laryngology and voice. There are multiple reasons for this. There is growing, significant basic science research that is allowing us to understand basic principles of laryngeal genetics, causes of injury and mechanisms of repair, and fundamentals of voice production and vocal fold vibration. A major innovation that has been in large part the driving force for advances in laryngology has been the development of better microscopes and rigid and flexible laryngoscopes. Dramatically improved optics and recording capabilities have taken this somewhat hidden organ into the light. This not only allows for better diagnostic capabilities and refinements of preventive, medical and surgical techniques, it has created an easy way to share pathology and treatment successes with patients and with the academic laryngeal community, thereby expanding the application of new and better techniques and technologies. The advent of microsurgical instrumentation that can be used safely through both a rigid laryngoscope under directed microscopic guidance or through flexible laryngoscopes with distal-tip cameras providing remarkable optics, affords precision that prior was a limiting factor in laryngeal surgery. There have also been advances in laser and other coagulation and ablation technologies that have further added to the capabilities of the laryngologist. These innovations have led to a dramatic shift in the location of laryngeal procedures so that many of them, such as injections, biopsies and laser surgery, are now done safely in the office setting.