<p>To evaluate Association between Autonomic dysfunction and Laryngopharyngeal reflux disease (LPRD) using COMPASS-31 Scoring system. Traditionally, LPRD was known to be condition in which there is retrograde flow of gastric contents into laryngopharynx but, as newer studies are emerging, its multifactorial pathophysiology is coming forth. Previous studies have focused on GERD and general autonomic function rather than specifically evaluating LPRD and using validated tool like COMPASS-31. This study aims to address this gap by investigating association between autonomic dysfunction and LPRD by using COMPASS-31 scoring system. This is cross-sectional study involving 160 participants, including 2 groups, 80 in diseased group suffering from LPRD and 80 in non-diseased group. They were evaluated using COMPASS 31 scoring system to find the association between autonomic dysfunction and LPRD. In this study, of 160 subjects, with 80 participants in each group, in diseased group, 40 were male and 40 were female. In non-diseased Group, 39 were male and 41 were female. In inter-group comparisons of means of components of COMPASS-31 score in diseased and non-diseased Groups, difference between two groups was not significant in mean Orthostatism score, mean Vasomotor score, mean Secretomotor score and mean Bladder score. Gastrointestinal score and Pupillomotor score were significantlyhigher in diseased group compared to non-diseased group. Mean ± SD of COMPASS-31 score in diseased and non-diseased Groups was 51.74 ± 13.70 and 46.09 ± 10.19 respectively. Distribution of mean COMPASS-31 score was significantly higher in diseased group compared to non-diseased group (P-value&lt;0.001). Autonomic dysfunction plays significant role in pathogenesis of Laryngopharyngeal Reflux Disease (LPRD). Owing to its multifactorial etiology, incorporating autonomic modulation into their therapeutic regimen for patients with refractory LPRD, could offer additional benefits, leading to better recovery.</p>