Objective: To review vocal outcome measures, using the Voice Related Quality of Life (VRQOL) index, after simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections. Study Design: Case series. Setting: Tertiary care academic clinic. Subjects and Methods: Fourteen subjects with abductor spasmodic dysphonia received 37 simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections for isolated abductor spasmodic dysphonia (ABSD) over a 16-month period. Main Outcome Measures: VRQOL index. Results: Of the 37 injections, 33 of 37 (89%) resulted in improvement. Three injections resulted in no improvement, and one injection resulted in a worse VRQOL. The overall VRQOL mean improvement was 19.8 (range 5-53), with an average pre/postinjection VRQOL interval of 36 days (range 21-45 days). Conclusions: Simultaneous bilateral posterior cricoarytenoid muscle botulinum injections result in a statistically significant improvement in VRQOL index scores for a high percentage of ABSD patients, thus improving patient quality of life. © 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation.