Hundred cases of precancerous laryngeal lesions were analysed on the basis of clinical pathology. The results showed that there was close relationship between the precancerous laryngeal lesions and voice abuse and long-term heavy smoking. The pathology showed epithelial hyperplasis and mild to severe atypical hyperplasia (heterotype). Scanning electronmicroscopy revealed that the more severe the degree of the epithelial heterotype, the more pleomorphic the shape of cell morphology, margin. Twenty cases had malignant changes later, and the rate of malignant change was high in those with atypical hyperplasia. Some lesions which were taken for polyps clinically and pathologycally could also have malignant changes, so more attention should be paid to these lesions during clinical management.