Upper Gastrointestinal endoscopy is extensively used these days and its various complications, including cardiopulmonary disease, bleeding, perforation and infection, have been reported on, but vocal cord paralysis as a complication of endoscopy has not been reported on. The pressure on the larynx by the endoscopic tip itself or the gag reflex during endoscopy could cause vocal cord paralysis as the endoscopic tip passes through the pyriform sinus, which is close to the recurrent laryngeal nerve and arytenoid cartilage. We experienced two cases of vocal cord paralysis as complications of upper Gastrointestinal endoscopy and we report on them here. (Korean J Gastrointest Endosc 2006;33:3236)