Laryngeal sarcoidosis, which was described by Poe1 in 1940, is a potentially life-threatening disease.2 However, it usually responds well to systemic therapy. The case reported herein represents an unusual presentation of the more aggressive cicatricial laryngeal sarcoidosis, which resulted in multiple recurrences that required tracheostomies. Pathologic examination revealed multiple nonnecrotizing epithelioid granulomas with extensive sclerosis. This typical appearance, in the absence of identifiable organisms, is consistent with the diagnosis of laryngeal sclerosing sarcoidosis.