Unilateral vocal fold paralysis (UVFP) is a common clinical entity in patients who consult a phoniatrician and significantly impacts a person's quality of life. The most common cause of unilateral vocal cord paralysis is injury to the recurrent laryngeal nerve (RLN), which occurs due to iatrogenic causes (surgical trauma), extralaryngeal malignancies, idiopathic and neurological causes, as well as non-surgical traumas. The clinical presentation and manifestations of UVFP include the loss of movement and muscle tone of the vocal fold, leading to incomplete glottic closure, which can result in dysphonia and aspiration. Diagnostic procedures include laryngoscopy, stroboscopy, and electromyography, which enable a detailed examination of structural and functional changes in the vocal folds. Current treatments for UVFP include voice therapy, injection laryngoplasty, medialization thyroplasty, arytenoid adduction, and laryngeal reinnervation techniques. The goal of any therapeutic approach is to restore normal phonatory function without aspiration. Voice therapy can be beneficial as a standalone treatment or combined with other interventions. Injection laryngoplasty is a minimally invasive procedure that involves injecting material into the vocal fold to achieve its medialization and augmentation. In contrast, medialization thyroplasty and arytenoid adduction are more invasive, but permanent surgical procedures that move the vocal fold closer to the midline to achieve better glottic closure. Laryngeal reinnervation techniques, such as direct RLN anastomosis, hypoglossal-RLN anastomosis, and ansa cervicalis-RLN anastomosis, are also used to restore muscle mass and tone of the vocal folds. The choice of therapeutic approach must be individualized for each patient, considering specific clinical circumstances and treatment goals.