Bilateral vocal cord paralysis in infants is seen so rarely that it warrants attention when found. In the absence of birth trauma associated with forceps delivery, it is usually due to central nervous system pathology. Report of a Case The patient was born Jan 22, 1962, the product of a normal pregnancy. He was physically normal except for a 0.5 cm defect in the occipital region of the skull from which protruded a 2.5 cm cystic lesion composed of a serous membrane wall which contained clear fluid. At 8 days of age, the lesion was excised. It was attached by an atretic stalk entering the skull defect. Microscopic studies showed the presence of meningeal tissue and established the diagnosis of occipital meningocele. Postoperative stridor was noted and attributed to the endotracheal anesthesia. It appeared to improve under steroid therapy, and the baby convalesced uneventfully. At 2 months of age, the