A prospective analysis of intracordal autologous fat injection for inferior laryngeal nerve paralysis of various origins was conducted in a series of 20 patients with a minimum 6 month follow-up. Adverse side effects were a sub-cutaneous abdominal hematoma, and a pseudo intracordal cyst in 1 patient. Aspiration, noted in 11 patients, disappeared immediately after the injection of fat in 10 patients. Subjective evaluation and objective acoustic recordings documented improvement in voice quality at 6 months. Three patients had a secondary reinjection of fat resulting in an overall 100% success rate. Such preliminary data, together with the review of the literature suggests, that intracordal autologous fat injection is a highly valuable treatment option in patients with unilateral inferior nerve paralysis.