Office-based laryngeal procedures comprise both diagnostic and therapeutic practices. They are an integral part of every laryngeal surgeon’s practice. Topical anesthesia is utilized effectively along with anticipatory guidance and proper patient positioning to maximize patient comfort and increase the success in procedure completion. Office laryngoscopy and stroboscopy are the gold standard for analysis of laryngeal anatomy and function. Office-based vocal fold injections and laryngeal laser ablation provide ample opportunity to safely move the correlate surgeries out of the operating room and into the office setting thereby minimizing the risk of the operations and associated general anesthesia.