Vocal cord paralysis (VCP) is an easily neglected complication after direct cardiac surgery and is associated with complications such as respiratory insufficiency, aspiration, dysphonia, feeding difficulties, and growth retardation in patients after extubation. The article focuses on the research progress of factors related to VCP, diagnosis, treatment, and prognosis after pediatric cardiac surgery, which provides a reference for clinicians to diagnose and manage VCP in the perioperative period to reduce postoperative complications and improve patient prognosis.