Vocal fold paresis is a relatively common diagnosis made by laryngologists and this is largely due to increasing awareness of this phenomenon over the last ten to fifteen years. The diagnosis however may not always be clinically relevant and thus one must always interpret it in the context of the presenting complaint. Therefore, this session will focus on the how to diagnose vocal fold paresis based on consistent clinical findings, the investigations used to do so and how to contextualize it within the patient’s clinical presentation. In this way we will aim to educate the attendees on which patients to intervene on, when to do so and how.