Background: We evaluated the incidence and assessed the severity of post-operative sore throat with standard versus smaller sized cuffed endotracheal tubes in patients undergoing laparoscopic surgeries. Method: Total 200 patients undergoing laparoscopic surgery were allocated in two groups; Group A: standard sized endotracheal tubes used i.e. 8.5mm for male and 7.5mm for female patients. Group B: smaller sized endotracheal tubes used i.e. 7.5mm for male and 6.5mm for female patients. The endotracheal intubation was performed with high-volume, low-pressure cuffed oral endotracheal tube. A manometer was connected to the pilot balloon and the cuff pressure was monitored. During intraoperative period, hemodynamic and respiratory variables were recorded at frequent intervals. In the postoperative period, coughing, sore throat and hoarseness of voice were recorded immediately after removal of endotracheal tube and thereafter at 1hr, 6hr,12hr and 24hrs. Result: Demographic variables were comparable (p > 0.05). The incidence and severity of postoperative sore throat was greater in Group A at all points of time (p0.05). Conclusion: This study highlighted the critical role of the size of endotracheal tube in the development of postoperative laryngotracheal morbidity in the form of sore throat, hoarseness and coughing in patients undergoing laparoscopic surgeries. A detailed comparison between the use of standard-sized and smaller- sized cuffed endotracheal tubes demonstrated that patients intubated with smaller-sized cuffed endotracheal tubes experienced a lower incidence and reduced severity of postoperative sore throat and hoarseness of voice.