Objective: We aimed to study the voice, voice-related quality of life (VRQoL) and health-related quality of life (HRQoL) of children who in early infancy underwent a laryngeal split (cotton plasty operation) at the Helsinki University Central Hospital between January 1990 and December 2005. Methods: A retrospective review identified 17 children, of whom 10 fulfilled the inclusion criteria and participated in the study. Age- and gender-matched volunteers formed a control group. We used generic 16D and 170 questionnaires to assess HRQoL; the Pediatric Voice Outcomes Survey (PVOS) and the pediatric voice-related quality of life (PVRQoL) instrument served to assess VRQoL. The children underwent indirect laryngoscopy and perceptual voice assessment. Results: HRQoL and PVRQoL scores did not differ between subjects and controls. The subjects had lower PVOS scores than did the controls (P < 0.01). Perceptual assessment revealed that the subjects' voices were worse off according to the following dimensions: voice is strained, voice is hoarse or husky, and voice is weak/does not resonate (P < 0.05). Conclusions: This study adds to the knowledge on the long-term effects of laryngeal split on children through assessment of their HRQoL and PVRQoL. The study subjects' lower PVOS scores and findings of perceptual assessment point to the effect of cotton plasty on VRQoL and voice. (C) 2010 Elsevier Ireland Ltd. All rights reserved.