The aim is to report a case of disseminated Paracoccidioidomycosis with dysphonia as the first manifestation. M.A.S, 46 years old, female, working in a rural area. In April of 2011, it was started with progressive dysphonia associated with productive cough and progressive odynophagia for solids to liquids. In the three months prior to the service, reported weight loss of ten pounds and dyspnea progressive. Smoking 35 packs / year. In the initial consultation, the patient presented with severe dysphonia, emaciated, with intense odynophagia and general condition. Auscultation diffusely decreased breath sounds, snoring and fine throes and wheezing. Otolaryngological examination, oroscopy, rhinoscopy and otoscopy normal. After laryngoscopy showed a lesion in the supra - the glottis, and diffuse whitish, underwent laryngeal microsurgery with biopsy, showing the macroscopic nodular lesion in the posterior region of the larynx, granulomatous, and subsequent pathologic anatomy compatible with laryngeal Paracoccidioidomycosis. X - Ray with bilateral interstitial infiltrate. Cervical Tomography corroborate with videolaryngoscopy. The larynx is often the site of granulomatous infectious diseases, dysphonia is the most common symptom, and biopsy is essential. Although Paracoccidioidomycosis is a rare disease, it is important to be remembered as a differential diagnosis in patients with a history of dysphonia dragged. To evaluate the merits of endemic regions, field workers, to examine all organs and systems in search of a diagnosis are crucial in the otolaryngology diagnosis, so we can diagnose disease early and not faced with advanced cases like the present report.