OBJECTIVE: To present the case of a pediatric patient with acquired vocal cord palsy and discuss the causes, management, and treatment. CASE REPORT: A male infant underwent cardiovascular surgery and presented with a hoarse cry and difficulty in breastfeeding after extubation. Flexible laryngoscopy showed immobility of the left vocal fold. The infant recovered spontaneously in 30 days. FINAL COMMENTS: Postoperative vocal cord palsy after cardiopulmonary surgery in children is not rare and is an important complication associated with increased comorbidity. Flexible laryngoscopy is the method of choice. Vocal fold immobility in pediatric patients can be congenital or acquired, and there are several treatment approaches. Symptoms vary with unilateral or bilateral involvement. We highlight acquired vocal cord immobility associated with cardiothoracic surgery to correct congenital cardiopulmonary anomalies. The priorities of treatment in these cases are to maintain airway patency and to ensure adequate nutrition. Corrective interventions in these patients can often be postponed because spontaneous recovery is common, but it is important to continue swallowing therapy.