General anesthesia has a low morbidity and mortality rate and is considered a safe procedure. Moderate hoarseness and sore throat are considered acceptable during the early postoperative period due to minor trauma even after first attempt noninvasive intubation. Vocal cord paralysis is an infrequent complication of endotracheal intubation. It also presents with hoarseness and that is why early diagnosis is difficult, especially if it appears after the orthognathic surgery procedure. There is only one case report of this complication after orthognathic surgery. In this case report, a 33-year-old healthy female patient who had unilateral vocal cord paralysis after bimaxillary orthognathic surgery is presented. Although hoarseness was the first symptom, it was considered as mild hoarseness due to intubation and could not be diagnosed in the early postoperative phase until the video-laryngoscopic examination was performed. Vocal cord paralysis lasted for five months and resolved spontaneously. Although very unusual, surgeons or anesthesiologists should be aware of this unpleasant complication and pay attention to vocal cord functions after orthognathic surgery. If there is no risk of aspiration, at least six months is required before performing any interventions.

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