Introduction: The VHI-10 is a patient-reported outcome measure used to record the patient's perception of impairment or handicap due to a voice problem. Scores above 11 are abnormal and indicate voice handicap. Amongst a treatment-seeking population in a large tertiary voice center, scores below the VHI-10 cutoff score of 11 were frequently noted. The aim of this study was to examine the number of people seeking voice therapy for dysphonia who scored below the established VHI-10 cutoff score. Methods: A retrospective chart review was completed of all patients attending a voice evaluation with a speech-language pathologist by referral of a laryngologist between February 1, 2017 and February 28, 2018. Patients aged 18+ years with a primary diagnosis of dysphonia were included. Sex, age, primary diagnosis, and VHI-10 score were recorded. Patients were categorized as scoring above or below the cutoff score of 11. Logistic regression was performed to determine the variables that predicted scoring below the VHI-10 cutoff. Results: A total of 225 patients were included. There were 91 males (40.4%) and 134 females (59.6%). Sixty-one patients (27.1%) scored below the VHI-10 cutoff of 11 at their evaluation. Younger age and male sex were predictive of scoring below the VHI-10 cutoff score. Diagnosis was not predictive of scoring above or below the cutoff score. Conclusion: A notable proportion of treatment-seeking patients scored below the VHI-10 cutoff of 11. If treatment-seeking behavior is related to patient perception of voice handicap, one would expect fewer patients to score below the cutoff. Possible explanations might include that the VHI-10 did not sufficiently capture patient perception of handicap in the study population or the published cutoff score may be too high. Alternatively, another motivator besides handicap may have spurred treatment-seeking behavior. Given these findings, additional or alternative patient-reported outcome measures may be useful in developing a complete clinical picture regarding voice handicap.