Three hundreds fifty nine patients who suffered from several laryngeal pathologies have been treated with the CO₂ laser for the last 5 years of the severance hospital. Five hundreds eighteen cases of CO₂ laser laryngeal microsurgery were reviewed for the evaluation of the CO₂ laser as surgical tool in laryngeal microsurgery. The results obtained from this analysis confirm that this instrument is a valid alternative surgical tool, because it allows the possibility carring out removal of the lesion with greater precision and effect. The results are as follows : Vocal polyp and Rinke's edema (116 patients, 119 cases) are removed safely with traditional procedures, whereas the CO₂ laser allows a more acurate excision of voluminous polyp with minimal trauma and bloodless operative field ; Vocal nudule (78 patients, 79 cases) : Some degree of advantage is offered by the CO₂ laser due to more precise removal without trauma to surrounding tissue ; Laryngeal Web (6 patients, 7 cases) is removed effectively by the CO₂ laser vaporization and keel insertion ; Other benign lesions (35 patients, 37 cases) such as laryngeal granuloma, intubation granuloma, contact granuloma, cyst, vocal cord synechia, laryngeal tuberculosis and laryngeal actinomycosis are easily removed with minimal trauma and functional impairments using the CO₂ laser ; Laryngeal anyloidosis (2 patients, 4 cases) : Advantages are offered by the CO₂ laser, considering the relatively diffuse laryngeal infiltration ; Precancerous lesions (32 patients, 35 cases) such as hyperkeratosis and erythroplasia : Better functional results can be obtained using the CO₂ laser, but postoperative follow-up evaluation is necessary to detect carcinomatous degeneration ; Laryngeal papilloma (43 patients, 115 cases) : The CO₂ laser makes it possible to achieve complete recovery if radical excision, avoidance of accidental laryngeal damage and postoperative serial control ; Laryngeal cacer (15 patients, 19 cases) : When clinical indications are correct, the main CO₂ laser advantages in the treatment of T₁ and T₂ glottic cancers are the endoscopic removal of the lesion, avoidance of tracheotomy, short hospital stay and better quality of voice ; Bilateral cord palsy (4 patients, 5 cases) : The CO₂ laser arytenoidectomy improve dyspnea in most cases ; Laryngotracheal stenosis (32 patients, 100 cases) : The CO₂ laser with T-tube insertion and or augumentation made it possible to decanulate in 14 cases (43%) ; In a small percentage of cases, complications such as recurrence, reactive hyperplasia, scar formation, misdirected burn in the anterior tracheal wall and endotracheal ignition were noted. But these complications could be avoid when clinical indications are exact and the surgical procedure is performed attentively.