With easier access to more sophisticated imaging techniques, the investigation of vocal fold palsy is reassessed. A questionnaire was sent to all ENT surgeons in the UK to establish which imaging techniques are available to ENT departments and which tests are currently requested during the investigation of vocal fold palsy. An extensive literature review established the aetiology of vocal fold palsy and the sensitivity and specificity of radiological investigations. A simple protocol is proposed which would be suitable to implement in the majority of ENT departments in the UK.