Background: Voice is an inherent means of communication intended to convey feelings of intimacy. One of the most frequent symptoms otolaryngologist’s encounters is hoarseness. The aims of this study are to determine the causes of hoarseness predisposing factors, to assess the clinical profile as well as how to evaluate and treat hoarseness of voice. To estimate the proportion of common causes of hoarseness in patients, identify predisposing factors and evaluate outcomes of various treatment methods. Methods: This was a cross-sectional study conducted at ENT department of tertiary care center. A total of 80 cases presenting with hoarseness were studied. A detailed history was taken, followed by a comprehensive local and systemic examination, leading to a clinical diagnosis supported by relevant investigations. Results: The most frequent cause of hoarseness of voice among patients was determined to be laryngeal cancer, with a 32.5% incidence rate. The incidence of hoarseness was 0.40% among the total ENT cases. Out of total 80 study subjects with hoarseness of voice 40% were from lower socioeconomic class, 30% had habit of smoking. Among them,35% were treated medically, 50% were treated surgically/radiotherapy and for remaining 15% study subjects no treatment was given. Conclusion: Therefore, based on this study, we conclude that hoarseness of voice is a primary symptom warranting investigation, as it could signal early laryngeal malignancy.