Conclusion: The first step when treating newborns and infants with hoarseness and dyspnea is to consider the possibility of CLSCs. The appropriate operation can then be chosen based on the cyst sub-type. Complete resection of the cyst wall is the key to preventing recurrence. Background: A laryngeal saccular cyst is an unusual congenital lesion that appears clinically during the neonatal period or early infancy. Because few reports on congenital laryngeal saccular cysts (CLSCs) exist, this study investigated the clinical features of patients with a history of CLSCs to determine the clinical characteristics of this disease. Methods: The data from 28 CLSC patients admitted to Beijing Tongren Hospital from July 2004 to September 2014 were reviewed. Gender, age at onset of symptoms, number of surgical procedures performed, effect of the operation, and CLSC classification were analyzed. Results: CLSCs accounted for 0.79% of laryngeal operations during the study period. Of the cases examined, 35.7% (10/28) had first been treated as laryngomalacia. With respect to cyst type, 17.9% (5/28) were anterior laryngeal saccular cysts, and 82.1% (23/28) were lateral saccular cysts. The patients underwent a total of 53 surgeries, including 21 procedures performed at other hospitals. The time to recurrence of the cysts following needle aspiration ranged from 5-10 days. The time to recurrence after the roof of the cyst was excised ranged from 1-10 months. There were no recurrences after the complete resection of the cyst wall using a CO2 laser and microsuturing of the wound surfaces via an endoscopic procedure, which is much better than the 41% of endoscopic de-roofing cases which recurred reported by Mitchell etal.