Twenty-four patients underwent crico-thyroidotomy at Guy's Hospital between 1977 and 1981. Of these, 13 died during admission or shortly after discharge as a result of their primary disease and three were unsuitable for further examination. The eight remaining patients were examined to assess the effect of crico-thyroideotomy on the laryngeal function of voice production. Assessment was made both subjectively and objectively by laryngography. Objective findings were correlated with structural changes seen by indirect laryngoscopy. Six of the eight patients examined had both subjective and objective disturbance of voice production. We report our experience with the surgical procedure of cricothyroidotomy which, in addition to a high incidence of vocal disturbance, includes one case of subglottic stenosis secondary to granulation tissue.