Subglottic hematoma or hemorrhage has been reported following blunt or pene-trating trauma to the larynx; however, phonotrauma has been rarely reported. In May 1993, we had an unusual experience of an old man presenting hoarseness and shortness of breath after a loud shout. Indirect laryngoscopy showed a solid gray mass about 2 cm in diameter over right subglottic area and it occupied more than half the airway space. Having perfomed tracheostomy and laryngomicrosurgery, the histopathological diagnosis was proved as organized hematoma. The mechanism, anatomy and treatment of subglottic hematoma following phonotrauma were discussed.