We have had a case of unilateral vocal cord paralysis following endotracheal anesthesia for abdominal surgery. Electromyographic examination of the intrinsic laryngeal muscle to study the nerve injury was not done but we have considered that the recurrent laryngeal nerve was injured following endotracheal anesthesia according to the post-operative laryngeal view and recovery progress. Som factors of nerve injury such as overrotation of the neck during the operation, pressure on the nerve by an overexpanded cuff, vulnerability and the anatomy of the nerve were all deemed to do possible causes, and we considered the interaction of this combination responsible for the nerve injury. The recovery were relatively good and healed within 80 dyas after operation.