Objective: Several studies have suggested that type of laryngeal biopsy may impact voice and vocal function, which may ultimately influence functional outcomes post cancer treatment. This study directly examined the impact of the biopsy procedure on voice outcomes for early glottic (Tis-T2) cancer patients.Design: Prospective pilot cohort study.Method: Fifteen patients diagnosed with early glottic cancer underwent voice recordings within one week pre-biopsy and between one-six weeks post-biopsy, via Sahlgrenska University Hospital, Sweden. A control group (n=15), matched for gender and comparable for age and smoking status, was assessed once only. Multidimensional voice analyses were conducted with both groups including: (1) Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) perceptual rating, (2) acoustic measures of harmonics to noise ratio, jitter, shimmer, mean spoken fundamental frequency and (3) Maximum Phonation Time (MPT).Results: In comparison to the control group, most perceptual and acoustic parameters were significantly (Pl0.05) more impaired both pre and post biopsy. No significant difference (Pg0.05) in the patient cohort was observed between pre-post biopsy voice parameters. At an individual level, half of the patients showed a perceived change in voice post biopsy, of which four demonstrated improvement and three a deterioration in vocal function.Implications: Although group level analysis did not show a significant biopsy-voice impact, individual data suggests that multiple, punch biopsies may negatively impact functional outcomes. The biopsy procedure is undoubtedly a necessary first step in laryngeal cancer management; however, given the emerging discussion regarding the type of biopsy technique, the nature and the extent of tumour/tissue removal on functional outcomes, this is an area for further research.