Objective To explore the clinical efficacy of low-temperature plasma radiofrequency ablation via suspension laryngoscopy for laryngeal and hypopharyngeal hemangiomas. Methods A retrospective analysis was conducted on the clinical data of 27 patients with laryngeal or hypopharyngeal hemangiomas admitted to Northern Jiangsu People’s Hospital from July 2014 to June 2023. All procedures were performed under general anesthesia with endotracheal intubation using plasma radiofrequency ablation. The operative duration and intraoperative blood loss were statistically analyzed. The postoperative pain score was evaluated using the visual analog scale (VAS) scoring system. Laryngoscopic follow-ups were conducted at 1 week, 2 weeks, 1 month, 3 months,and 6 months postoperatively to evaluate treatment outcomes. Results All 27 patients underwent smooth surgeries, Operative duration: (32.59±14.83)min; Intraoperative blood loss: (35.56±42.67)mL (median 20 mL); Postoperative pain (VAS score): (2.26±1.20) mild pain. Only 1 patient experienced severe intraoperative hemorrhage requiring tracheotomy and ligation of the ipsilateral superior laryngeal artery. Conclusion Low-temperature plasma radiofrequency ablation via suspension laryngoscopy is a safe and effective treatment for laryngeal and hypopharyngeal hemangiomas, characterized by short operative time, minimal blood loss, and mild postoperative pain. It is worthy of clinical promotion and application for its minimally invasive advantages and reliable outcomes.