The presbyphonia is a combination of physiological and structural changes due to aging of the larynx in elderly patients with voice problems. Some of these changes are inevitable, while others may be avoidable or reversible. The fatigue of phonation is the most common clinical symptom of the aging voice. The voice problems with aging are produced from variable causes including the organic lesions of the larynx. It is essential that the curers understand physiologic and pathologic changes of aging voice for minimizing glottal incompetence and improving vocal performance and quality of life of the elderly.