Objective To investigate the diagnostic value of laryngeal electromyography (LEMG) in vocal cord dysfunction(VCD) after surgery. Methods A retrospective analysis was performed on 38 patients with VCD after general anesthesia, which were involved in a comprehensive diagnostic and treatment process based on relevant medical history, flexible laryngoscopy, three-dimensional CT of the larynx, subjective perceptual assessment of voice GRBAS(grade degree，rough，breath，asthenia，strain), and LEMG. Results Among the 38 patients, there were 20 cases in the recurrent laryngeal nerve palsy group and 18 cases in the cricoarytenoid dislocation group. Voice analysis showed that 33 cases had moderate to severe hoarseness (G2~3). Laryngeal three-dimensional CT showed anteromedial or posterolateral dislocation of cricoarytenoid joint. In the group of recurrent laryngeal nerve palsy, 13 out of 20 patients underwent LEMG examination, which indicated that the recurrent laryngeal nerve was not completely damaged. The results of 4 patients showed that the recurrent laryngeal nerve was completely damaged. The recruitment potential of cricothyroid muscle was weakened in 3 patients with indicating simultaneous injury of superior laryngeal nerve. LEMG results showed that the dislocation of cricoarytenoid joint was normal in 11 of the 18 patients, and mildly abnormal in 7 of the 18 patients. Among the 20 patients with recurrent laryngeal nerve palsy, 16 cases of them had significant improvement in voice quality (G0~1) after medication plus voice training therapy or vocal cord fat injection treatment. The remaining 4 patients without treatment unilaterally relied on the contralateral vocal cord compensation with poor voice recovery (G3). In the group of 18 patients with dislocation of cricoarytenoid joint, they were treated with cricoarytenoid joint reduction and voice training after operation. Satisfactory results were obtained in 17 of 18 cases (G0~1). Conclusion Postoperative VCD is the main cause of hoarseness after surgery. LEMG can make qualitative diagnosis of recurrent laryngeal nerve paralysis or cricoarytenoid dislocation, which can guide clinical treatment. It is helpful for the patient to recover as soon as possible.