【Abstract】 Objective To investigate the role of laryngeal electromyography in diagnosis and treatment of vocal cord dysfunction after surgery. Methods A retrospective analysis of 38 cases of patients with vocal cord dysfunction after general anesthesia, involving 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), and results from laryngeal electromyography. 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 33 cases of moderate to severe hoarseness (G2-3). Laryngeal three-dimensional CT showed cricoarytenoid joint dislocation group, showing anteromedial dislocation or posterolateral dislocation; there was no abnormality in the cricoarytenoid joint in the recurrent laryngeal nerve palsy group. LEMG showed that among the 20 patients in the recurrent laryngeal nerve palsy group, 13 patients underwent LEMG examination, and the results suggested 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, indicating that the superior laryngeal nerve was damaged at the same time. Among the 18 patients with cricoarytenoid joint dislocation, 11 patients had normal LEMG results and 7 patients had mild abnormalities in LEMG. After treatment, 16 of the 20 patients in the recurrent laryngeal nerve palsy group were treated with drugs and voice training, or vocal cord fat injection, and the voice quality was significantly improved (G0-1). The remaining 4 patients did not receive treatment, unilaterally relied on the contralateral vocal cord compensation, and the voice still recovered poorly (G3). In the cricoarytenoid dislocation group, 18 patients were treated with cricoarytenoid joint reduction and voice training after operation. Most of them could also achieve satisfactory results (G0-2). Conclusion Vocal cord dysfunction is the main cause of hoarseness after surgery. Laryngeal electromyography 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.