Due to a hoarseness or dysphonia about 1 % of patients consult a doctor. The causes of hoarseness are very diverse and can range from a harmless laryngitis to vocal cord tumors. In addition to acute and chronic laryngitis (42 % and 10 %), functional dysphonia (30 %), benign (15 %) and malignant tumors (3 %), vocal cord paresis (5 %), the physiological aging voice (2 %) and psychogenic factors (2 %) can cause hoarseness. The manifestation of internal diseases is very rare. Treatment options depending on the cause are drugs, voice therapy or surgery. The present article gives an overview of possible causes of hoarseness, diagnosis and treatment options. Hoarseness lasting more than three weeks should always be taken seriously and be examined laryngoscopically.