Aims This study aims to evaluate the role of laryngeal ultrasounds as an adjunct for diagnosis and monitoring of vocal cord function at Perth Children’s Hospital. We aim to review the feasibility and accuracy of laryngeal ultrasounds at our institution in comparison to the gold standard endoscopic assessment. We believe that this would provide an insight into the value of utilizing laryngeal ultrasound as a non-invasive and readily available modality in all levels of paediatric health care. Methodology 207 paediatric patients were identified from mClinical Power Analytics, to have received a laryngeal ultrasound for vocal cord assessment from 2019 to October 2025. A retrospective review is completed using this data. Their medical records were analyzed and tabulated. The outcomes studied include patient demographics, methods of vocal cord palsy/paresis (VCP) diagnosis, causes of VCP and correlation with endoscopic findings. Results The accuracy of laryngeal ultrasound and nasoendoscopic findings are comparable between the two modalities at our institution. Laryngeal ultrasounds are requested by other specialties other than ENT as means for initial assessment of vocal cord function while ENT teams tend to request laryngeal ultrasounds as an adjunct for surveillance and diagnosis when nasoendoscopy is inconclusive. The most common reason for investigation is stridor and dysphonia and the most common aetiology of VCP is iatrogenic causes, particularly cardiothoracic surgery. Conclusion Laryngeal ultrasound is a valuable adjunct for assessing vocal cord function. It serves as a good modality for surveillance without subjecting children to a nasoendoscopy unnecessarily. It also allows other specialists to obtain an initial assessment which could be helpful in centres without an ENT service. More training should be provided on how to perform laryngeal ultrasounds particularly in the paediatric population as it is non-invasive, quick and tolerable by most children.