Vocal cord palsy as a result of tonsillectomy in local anesthesia is a very rare complication. In literature, there is only few publication describing this side effect of tonsillectomy. We present a case of 26 years old men who was classified for surgical removing of tonsils in local anesthesia using 1% lignocaine with 1:100 000 epinephrine. During the procedure respiratory failure with stridor was developed, examination using indirect laryngoscopy show bilateral vocal chord palsy. The authors present probably pathomechanism of this complication.