We report a case of fish bone impaction in the paraglottic space, which caused palsy of the left vocal cord. The patient was a 45-year-old man. He presented with throat pain and hoarseness of voice for approximately one week. The diagnosis was made after careful history taking and confirmed by the use of computed tomography scan as the fish bone was not visible endoscopically under local and general anaesthesia. The patient underwent thyroid cartilage window approach, and the fish bone was retrieved. His symptoms have improved significantly, and he did not require tracheostomy. Other cases reported the removal of foreign bodies by other techniques such as laryngofissure and posterolateral approach. Our case is different in that we used a modification of thyroplasty type 1 technique as it has less reported complications than other approaches that were published in literature.