Treatment of benign and malignant laryngeal lesions has been advanced through microsurgical visualization. Using suspension laryngoscopy, combined with the appropriate anesthetic techniques, precise surgical treatment of vocal cords can be properly undertaken. Microscopically controlled excision can be performed to within 0.2 mm of the lesion using a CO2 laser. Additional applications of microscopically controlled laser will be applied to laryngeal lesions in the future and will further enhance precise and safe treatment.