Introduction Laryngopharyngeal reflux (LPR) is defined as the retrograde flow of gastric content into larynx and pharynx. It is a multifactorial syndrome. Empiric trial of PPI therapy represents the first step to confirm LPR and to treat it accordingly as all currently available diagnostic tests have poor sensitivity and specificity. However, there is no accepted protocol for the most effective treatment of patients with LPR. Objective of the study was to assess the effect of Rabeprazole on pachydermia laryngis (posterior commissure hypertrophy) in patients with LPR. Materials and Methods In this prospective study, 75 subjects diagnosed with LPR using Reflux symptom index (RSI) and Reflux finding score (RFS) tools were recruited. Using RFS, posterior commissure hypertrophy was scored at presentation and after 8 weeks of rabeprazole therapy. The mean pre- and post-treatment posterior commissure hypertrophy scores for each patient were compared using paired T-test. Results Posterior commissure hypertrophy did not show statistically significant improvement following 8 weeks of 20 mg once daily oral rabeprazole therapy. Conclusion Eight weeks of oral therapy with Rabeprazole 20 mg once daily did not show statistically significant improvement in posterior commissure hypertrophy.