Laryngeal manifestations of gastro-esophageal reflux disease (GERD) are difficult to measure objectively. We performed a quantitative assessment of voice quality in patients with GERD and compared them with a normal population. METHODS: 93 volunteers completed a symptom questionnaire. 59 were asymptomatic, 34 had GERD symptoms at least once a month. 20/34 with GERD had 24 hr pH studies, 15/20 (75%) being positive (DeMeester score >14.7) Of those with GERD, 7/34 (21%) had clinically identified voice abnormalities and 27 had a normal voice. All subjects read a standardised text whilst laryngograph measurements of impedance across the larynx and vocal cord contact were obtained by means of electrodes applied to the neck. Parameters measured were percentage irregularity of voice frequency (CFx) and the proportion of vocal cord contact during each opening/closing cycle (CQx). RESULTS: Mean % CFx was 27.9 (sd18) in normals; 38.6 (sd25) in GERD (p=0.04). Mean % CQx was 53.2 (sd14) in normals, 58.2 (sd18) in GERD (p=0.18). For those with GERD, CFx values are similar irrespective of clinical voice impairment: voice impaired, n=7, CFx 38.3 (sd33.3); normal voice, n=27, CFx 38.6%  (sd24.3).