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Aim:To compare laryngeal preservation rates, survival rates, and voice outcomes after treatment of early glottic cancer between transoral laser microsurgery (TLM) and radiotherapy (RT). Materials and methods:A review of oncologic results was performed on a consecutive series of individuals with early-stage glottic carcinoma (T1 and T2) who were treated between 2011 and 2014 at Kidwai Memorial Institute of Oncology and had received either RT or TLM. Data were collected with a view to assess overall survival, disease-specific survival, laryngectomyfree survival, and laryngeal preservation rates. The Voice Handicap Index-30 (VHI-30) was used as the measure of voice quality after treatment. Results:Two-year overall survival for TLM group was 93.8% and for RT group was 90.5%, p = 0.643. Disease-free survival (TLM = 90.6% vs RT = 76.2%) was not found to be significant (p-value = 0.104). Laryngeal preservation rate was 79.5% in TLM and 71.4% in RT group (p-value = 0.003). Laryngectomyfree survival was better in TLM (TLM = 96.9% vs RT = 76.2%, p = 0.003). Substage analysis showed equivalent voice for TLM (VHI = 6-12) and RT (VHI = 6-14) in T1a patients (p = 0.94), whereas voice outcome was better for RT in T1b (VHI = 10-16 for TLM vs VHI = 11-18 for RT, p = 0.044) and T2 (VHI = 21-29 for TLM vs VHI = 16-23 for RT, p = 0.002) stages. Conclusion:Transoral laser microsurgery can be considered the treatment of choice for early glottic cancer in view of better IJHNS