Purpose of the review: The purpose of this review is to describe the surgical approach to benign superficial lesions of the larynx. It will discuss the microanatomy of the layered vocal fold structure and how this impacts decisions as to how to approach such lesions and the appropriate surgical instrumentation that helps to facilitate safe and effective surgery. A number of common lesions will be presented along with the various surgical techniques that allow for maximizing the surgical results, preventing recurrence and minimizing risks.