ObjectiveTo report patient tolerance in office‐based blue laser therapy for vocal fold lesions.MethodsA retrospective review of the medical records of patients who underwent office‐based blue laser therapy for lesions of the vocal folds between November 2021 and February 2023 was conducted. A total of 48 patients were included. Patient tolerance was assessed using the Iowa Satisfaction with Anesthesia Scale (IOWA). Patient tolerance was analyzed in relation to patients' demographic characteristics, disease type and severity, and procedure‐related factors.ResultsThe mean tolerance score of the study group was 1.51 ± 1.1. There was a significant difference in the mean tolerance score between smokers and non‐smokers (p = .038). Patients with vocal fold cyst (n = 3) had the highest mean tolerance score followed by patients with vocal fold polyps (n = 15). There was a nonsignificant difference in the mean tolerance score between benign lesions of the vocal folds and leukoplakia. Patients with lesions extending to more than half the vocal fold had less tolerance than those with lesions limited to less than half the vocal fold (1.91 vs. 1.27, p value .041). There was a moderate and significant negative correlation between vocal fold movement VAS, swallowing VAS, and tolerance score. The mean total duration of the procedures was 10.38 ± 4.8 min. There was a mild negative correlation between the duration of the procedure and tolerance.ConclusionOffice‐based blue laser therapy for vocal fold lesions is a well‐tolerated procedure. Patient should be instructed how to breathe quietly and avoid swallows to improve tolerance to surgery.Level of Evidence4.