The standard treatment for patients with T1a vocal cord cancer has been radiotherapy. From October 1995 selected patients have undergone laser surgery and up until March 1997 we had treated 16 patients. The results so far have been satisfactory with only one recurrence. Some of the patients have experienced a slight to moderate degree of hoarseness postoperatively. Laser treatment is more cost-effective than radiotherapy and in larger series the incidence of residual disease and recurrence seems to be equal to or even better than when following radiotherapy. The procedure demands considerable skill with laser surgery of the larynx and should be limited to 1-2 surgeons at two hospitals in this country where the annual incidence of T1a glottic cancers is approximately 30.