Presbyphonia is a change in the voice resulting from physiological changes related to aging. These changes involve the entire person but particularly include changes related to the laryngeal structures. In the majority of elderly people with vocal symptoms the cause is multifactorial and specific laryngeal lesions should be pursued. Metabolic, autoimmune and neurologic diseases are more common in the elderly and should be ruled out as well. Patients present with several characteristic symptoms that include vocal weakness, reduced projection, changes in pitch and vocal fatigue.