A vocal cyst is a mass in the vocal fold which is usually a collection of mucus surrounded by a membrane. Vocal cysts are usually located below the surface associated with a layer very important for normal voice function. Cysts may form in connection with phonotrauma, or perhaps from other irritants, or randomly. Cysts are not a health concern but cause hoarseness that is difficult to treat. Unlike some other benign lesions of the vocal folds, vocal cysts usually do not respond to conservative treatment. Voice rest and speech therapy may help to soften and resolve swelling associated with cysts, but the vocal cysts themselves remain. Usually vocal cysts require removal by microscopic laryngeal surgery. This technique requires considerable experience and microsurgical skill because the cyst needs to be removed in its entirety in order to minimize the chance of recurrence. Also, great care is taken to minimize the chance of scar since scar and cysts can often produce similar types of hoarseness. For patient’s undergoing surgery, voice therapy is almost always recommended in order to maximize healing.