Introduction: The vocal process granuloma has many causes, including intubation trauma, reflux and vocal abuse. The recurrence rate after surgical dissection is 54%. Objective: This paper reports three cases of vocal fold granulomas without benefits after clinic management and phonotherapy who underwent surgery for removal of the lesions and application of botulinic toxin type A in the thyroarytenoid muscle, with no recurrence of the lesions. Conclusions: The surgical treatment of the vocal process granuloma associated to the injection of botulinic toxin may be a reasonable alternative to large lesions or to those without satisfactory response after clinic management and phonotherapy.