Abstract: Objective: To investigate the advantages of applying microdebrider removal of juvenile-onset recurrent respiratory papillary epithelioma (JO-RRP) using an endoscopy-assisted prop-up laryngoscope. Methods: The neoplasms were scored based on the degree of severity (i.e. 1 point for a slight degree, 2 points for a moderate degree and 3 points for a severe degree). The involvement of 22 respiratory and digestive regions was evaluated and the neoplasms were scored, and the scores for the lesions in the vocal area were also calculated and subgrouped. All of the papillary epitheliomas were excised using a laryngeal microdebrider or microlaryngeal forceps under endoscopy-assisted suspension laryngoscopy. Parameters assessing the two treatment modes were compared for the cases grouped by score as follows: the operation time, interval between operations, vocal quality after operation, postoperative scarring and incision of the trachea , as well as the distribution of tumors in a repeat operation. Results: The 142 operative procedures were performed in 33 pediatric patients, with application of a laryngeal microdebrider in 14 cases and excision in 19. Compared to the excision group (EG), the laryngeal microdebrider group (MDG) displayed many superior features, such as a shorter operation time, longer interval between operations, obvious improvement in vocal quality soon after operation, and a lower frequency of subsequent tumors. There was a significant difference between these procedures. A postoperative incision of the trachea was required in 2 cases of EG, whereas no repeat operation was needed in the MDG. Conclusion: There are many advantages to using laryngeal microdebrider removal of JO-RRP. The procedure is simple and convenient, has a distinct operating field with a precise incision and minor wounds, and displays fewer complications and better vocal quality soon after operation, as well as quicker rehabilitation and longer intervals between operations.