Objective To discuss the clinical application and perioperative nursing management of CO2 laser phonomicrosurgery. Methods A total of 135 laryngeal disease patients received systematically evaluation as well as mental care before CO2 laryngeal laser surgery. We helped surgeon to fully expose operative field and monitor vital signs during the surgical process. In addition, careful observation and nursing were necessary to reduce the incidence of postoperative complications. Results Perioperative mental status of 135 patients were good, as well as steady vital signs and successful operation. None of them got laser accident during the surgical process. The laryngeal disease of all patients had different degree recovery when they discharged. Conclusions CO2 laser phonomicrosurgery has obvious superiority and innovation in the voice disorder surgery, and well perioperative nursing plays a pivotal role in the postoperative recover. Key words: Larynx; Perioperative nursing; CO2 laser; Safety protection