Objective To investigate the value of narrow-band imaging training for differentiating between benign and malignant vocal fold leukoplakia. Method Thirty cases of vocal fold leukoplakia were selected. Results Narrow-band imaging endoscopy training had a significant positive effect on the specificity of the differential diagnosis of vocal fold leukoplakia. In addition, the consistency of diagnostic typing of vocal fold leukoplakia by narrow-band imaging improved to ‘moderate agreement’ following the combination of types I and II and the combination of types IV, V and VI in the typing of vocal fold leukoplakia. Conclusion The narrow-band imaging training course may improve the ability of laryngologists to diagnose vocal fold leukoplakia. The new endoscopic diagnostic classification by narrow-band imaging needs to be further simplified to facilitate clinical application.