To evaluate endoscopic CO2 laser arytenoidectomy(ECO2LA) for the treatment of bilateral vocal cord paralysis (BVCP).Eight cases have been operated upon and observed for 6 to 40 months. Three of them were extralaryngeal approach artenoidectomy failures. All of them had tracheostomy before. The technique was to modification of Ossoff ECO2LA model. A small part of ventricular fold and posterior part of vocal cord was vaporized by laser. The mucoperichondrium overlying the arytenoid was reserved and sutured. After 3 months the opposite arytenoid was treated similarly.There were no aspiration and no granulation at the surgical site postoperatively. All cases kept satisfactory voice. Five of 8 patients were decannulated. Two patients still had laryngeal stridor during sleep and they had to plug the tracheotomy tube only on daytime. One patient had cannula retained for waiting operation on the opposite side.ECO2LA is currently a most reliable and efficient technique for treatment of patients with BVCP.