Improved hygiene and public awareness have led to a steady decline in the incidence of pulmonary tuberculosis in developed countries. Nonetheless, long-term sequelae like unilateral vocal fold paralysis should not be underestimated in a modern society. We report three patients with chronic lung fibrosis following pulmonary tuberculosis leading to unilateral vocal fold paralysis. All three patients had hoarseness and chronic aspiration on swallowing. Early diagnosis and prompt surgical intervention are essential if this potentially fatal complication is to be prevented.