Background: Hoarseness is one of the first and only serious local and systemic disease. Hoarseness is defined as perceived, rough,harsh,breathy quality of voice. The pathophysiology of hoarseness is characterized by muscle tone related irregularity in the osscillation of the vocal cords owing to hypertonic dysphonia, incomplete closure of the glottis on vocalisation or an increase in vocal cord bulk,perhaps due to tumor1 ,2. Method: It is a prospective study. 50 Patients selected on simple random selection technique,all patients between age group of 2-70 years with history of hoarseness of voice, attending E.N.T. outpatient department VIMS and patients referred from other departments in Vijayanagar Institute Of Medical Sciences combined group of Hospitals, Ballari, over a period from November 2019 to May 2021. Results: In our study , vocal cord polyp was most common lesion in 11 (22%)patients, next common is the vocal cord palsy seen in 10(20%) patients , vocal nodule seen in 7(14%) patients .5 each patients had supraglottic malignancy(10%) and vocal cord growth(10%) . Hypopharyngeal malignancy is seen in 3 patients(6%). Tonsillar malignancy seen in 2 patients(4%) . one each patients were seen in epiglottic cyst(2%), subglottic malignancy(2%),laryngeal papilloma (2%),vocal cord haemangioma (2%),vocal cord haemorrage(2%), reinke’soedema(2%) and vocal cord oedema(2%). Conclusion: In our study , vocal cord polyp was most common lesion, followed by common is the vocal cord palsy, vocal nodule, supraglottic malignancy, vocal cord growth, Hypopharyngeal, Tonsillar malignancy, epiglottic cyst, subglottic malignancy, laryngeal papilloma ,vocal cord haemangioma ,vocal cord haemorrage, reinke’soedema and vocal cord oedema. And the aetiological factors were voice abuse, smoking, tobacco, beetel nut chewing