Vascular ectasia refers to enlarged or fragile blood vessels on the vocal folds, often due to long-term vocal strain, aging, or hormonal changes. These dilated vessels can rupture with vocal stress, increasing the risk of hemorrhage. Patients may notice a rough, unstable, or breathy voice and may be at risk of sudden vocal fold bleeding. Treatment focuses on reducing the risk of rupture. This includes voice therapy, reflux control, and in some cases, laser therapy. We often use blue laser or KTP laser to shrink these fragile vessels in the office or during microlaryngoscopy. Voice rest is recommended post-procedure, and most patients recover fully within a week.