Hoarseness is a common presenting symptom in patients referred to the otolaryngology clinic. An arteriovenous malformation (AVM) in the neck is a previously unreported cause of hoarseness. We describe the case of a 61-year-old woman who presented with hoarseness and vocal fold paralysis, which was caused by an AVM. She was successfully treated with endovascular embolization. Devascularization of the AVM resulted in symptomatic relief of the hoarseness and resolution of the vocal fold paralysis, presumably secondary to interval reduction in edema and venous congestion.