The purpose of this retrospective study was to describe and evaluate the results of arytenoidopexy performed by the external laterocervical approach in 15 consecutive children presenting bilateral vocal fold paralysis causing life-threatening airway compromise. Mean age at the time of surgery was 20 months and mean follow-up was 42 months. At the end of follow-up all patients were in good health and did not need special care for breathing. No abduction movement has been observed on the opposite vocal fold since arytenoidopexy. One failure subsequently required arytenoidectomy. The findings of this study suggest that arytenoidopexy is an effective surgical treatment for life-threatening bilateral vocal fold paralysis in young children.