Bilateral vocal cord paralysis refers to bilateral vocal cord dyskinesia caused by damage to the nerve conduction pathway that controls muscle movement in the throat. It is the second most common congenital laryngeal disease in children. The main symptoms are upper airway obstruction, stridor and hoarseness. The etiology of bilateral vocal cord paralysis includes neurologic, iatrogenic, idiopathic and other etiology. It could be performed for clinical evaluation of etiology, vocal cord motion vibration, imaging, laryngeal electromyography and laryngeal ultrasound. The main goal of treatment is to relieve respiratory obstruction, and to restore the physiological function of the larynx. Treatment options include invasive positive pressure ventilation, tracheostomy, annular cartilage dehiscence, diploidous cartilage resection, posterior vocal cord tomy, vocal cord exotaxis, selective laryngeal nerve repair, botulinum toxin injection into the internal laryngeal muscle, and other emerging treatments.