Objective: To determine if selective reinnervation of the cricothyroid muscle could be achieved with musclenerve-muscle neurotization. Design: Case series. Setting: Tertiary referral center. Patients: Three consecutive patients with high vagal lesions that resulted in unilateral laryngeal paralysis. Interventions: Patients underwent laryngeal reinnervation with ansa hypoglossi to recurrent laryngeal nerve anastomosis. In addition, patients underwent selective cricothyroid muscle reinnervation by muscle-nervemuscle neurotization technique. Main Outcome Measures: Objective and subjective improvement in voice quality and electromyographic evidence of selective reinnervation of the cricothyroid muscle. Results: All patients recovered normal or near-normal speaking voice and had normal objective measures of voice quality. They also showed electromyographic evidence of cricothyroid muscle reinnervation. Conclusion: The muscle-nerve-muscle neurotization technique was successful in providing selective reinnervation of the cricothyroid muscle in our 3 patients.