Objectives: In this study, we retrospectively reviewed and intended to further compare the treatment outcomes and complications of office transnasal vocal fold polypectomy (TVFP) with those of microplarygoscopic surgery (MLS) for different clinical and histopathological features of broad-based sessile vocal fold polyps. Methods: We retrospectively reviewed the records of 159 consecutive patients with broad-based sessile vocal fold polyps treated by TVFP or MLS. The differences in efficacy and complication between these two surgical techniques were compared according to the different types of vocal fold polyps. Results: Satisfactory outcomes of both TVFP and MLS treatments were reported in patients with edematous, gelatinous and vascular types of vocal fold polyps (p > 0.05). The efficacy of TVFP was slightly worse than MLS in fibrous polys group (p < 0.05). The TVFP-treated patients did not exhibit obvious complications, whereas several MLS-treated patients had suffered different complications. Conclusion: The therapeutic effects of both TVFP and MLS on the treatment of broad-based sessile vocal cord polyps are related to their clinical characteristics and histological types. Satisfactory outcomes are achieved in edematous, gelatinous, and vascular types of polyps after either surgical procedure. TVFP has fewer surgical complications than MLS which can be a preferred option for the treatment of broad-based sessile vocal cord polys at outpatient setting. TVFP also can be an alternative surgery option for patients who could not tolerate general anesthesia or laryngeal suspension. In contrast, MLS has proven to be particularly advantageous in patients who have fibrous type of polyps.