The treatment of unilateral vocal fold palsy (UVFP) or bilateral vocal fold palsy (BVFP) has been the subject of debate and experiment for 150 years. To date, dozens of different surgical methods have been described to reinnervate this most complex of organs, the larynx. As yet, there is no consensus on the most functionally effective method of reinnervation. However, it is a rapidly expanding area of research and remains an area of controversy. Indications for reinnervation for both UVFP and BVFP are still evolving and our understanding of the neuromuscular supply to the larynx continues to expand.