A full-term newborn developed respiratory compromise in the immediate postparturition period requiring urgent intubation. Evaluation of post-extubation stridor later the same day revealed an avulsion injury extending from the left vocal fold into the lateral glottic musculature. Primary repair was accomplished with anatomic realignment of the torn vocal fold and muscle. Endotracheal intubation was utilized for stenting and the patient was extubated following 3 days of paralysis with sedation. Follow-up examination revealed a reparative granuloma, which was lasered. Eight-week follow-up examination revealed normal vocal fold architecture. At 18 months the patient continues to have a normal voice and normal laryngeal development.