Objectives. To investigate the characteristics and clinical application of Mandarin Chinese version of the Voice Handicap Index (VHI). Methods. A cross-culture adaptation was used to develop the Mandarin Chinese version of the VHI. The translated version was then administered to 1766 dysphonic patients and 120 control subjects; 210 of the patients were treated with phonosurgery or BOTOX injection. Disorders were chronic laryngitis, benign vocal fold disorders, pathologic sulcus vocalis, benign or malignant tumors of vocal fold, spasmodic dysphonia (SD) and unilateral vocal fold paralysis (UVFP), and functional dysphonia. Results. The Cronbach's a score for the overall VHI was 0.956; the functional, physical, and emotional subscales had values of 0.922, 0.872, and 0.933, respectively. The test-retest reliability coefficient was 0.991 (P < 0.01). Correlations between the subscales and the overall VHI as well as among the subscales were all significant (P < 0.01) Principal-component analysis revealed six-factor eigenvalues exceeding I, explaining 75.39% of the total variance. The total VHI scores and subscale scores were statistically higher for dysphonic groups (P < 0.001). The order of disease classification from highest score to lowest score was: SD, functional dysphonia, UVFP, sulcus vocalis, benign and malignant tumor, benign vocal fold disorders, and chronic laryngitis. The emotional scores were the highest in SD, and followed by functional dysphonia; the physical scores were the highest in the other groups. Treatment leads to statistically improvement in VIII scores (P < 0.05). Conclusion. The Mandarin Chinese version of VHI appears to be a reliable and valid tool in assessing dysphonia in Mandarin Chinese speakers.