Since the introduction of antituberculous medications, the incidence of laryngeal tuberculosis (TB) has decreased and remains stable. However, with the incidence of TB increasing, mainly caused by the acquired immunodeficiency syndrome epidemic, the incidence of laryngeal involvement may be on the rise. The main presenting symptom of laryngeal TB is dysphonia. The diagnosis is confirmed with the identification of granulomatous inflammation, caseating granulomas, and acid-fast bacilli on histopathologic examination of biopsied laryngeal tissue. However, making the diagnosis difficult can be the presence of pseudoepitheliomatous hyperplasia, which mimics squamous cell carcinoma. Treatment is primarily with antituberculous medications with surgery reserved for those cases of airway compromise. Laryngeal complications can occur; thus, long-term follow-up is recommended. We report a case of laryngeal TB in a human immunodeficiency virus-negative patient and review the literature.