We report the case of a 54-year-old woman who presented for evaluation of deterioration in her voice and swallowing function, which had begun after she had undergone a medialization laryngoplasty for unilateral vocal fold paralysis. Findings on examination and imaging revealed that a mass had developed adjacent to the Silastic implant that had been placed during the laryngoplasty. The superior extent of the implant reached above the laryngeal ventricle. Endolaryngeal surgical resection of the mass was accomplished without the need to remove the implant. Pathologic analysis identified the mass as a laryngeal saccular cyst. Although laryngeal saccular cysts are uncommon, medialization laryngoplasties are not. This case represents a rare complication of medialization laryngoplasty in which an implant compressed the laryngeal saccule and led to formation of the cyst.