Inflammatory, benign, and pre-malignant lesions of the vocal folds are common causes of dysphonia. Risk factors include phonotrauma, reflux disease, smoking, and other external stressors such as noise and pollution. Different vocal fold pathologies may exhibit distinctive histologic characteristics. In rare cases, laryngeal cancer may be the cause of dysphonia. This chapter provides an overview of the most common structural voice disorders in patients presenting with hoarseness.