Abstract Objective To evaluate the long‐term treatment outcome of type 1 thyroplasty with novel rearrangeable titanium medialization laryngoplasty implant (TMLI) combined with arytenoid adduction (AA) for unilateral vocal cord paralysis (UVFP) in the authors' institution. Methods A total of 16 Japanese patients with UVFP who received type 1 thyroplasty using TMLI with arytenoid adduction was enrolled in this single‐arm, non‐randomized interventional study. The results of the auditory perceptual assessment, aerodynamic examination, acoustic measurement, and patient‐based survey on these patients were evaluated preoperatively and at 3, 6, and 12 months postoperatively. Results Type 1 thyroplasty using TMLI with arytenoid adduction for our patient series presented significant improvements in maximum phonation time, mean flow rates, GRBAS scale, the Voice Handicap Index and the Voice‐Related Quality of Life score over the 12‐month postoperative period. Conclusion Type 1 thyroplasty using TMLI with arytenoid adduction was quite effective for obtaining satisfactory postoperative voice improvement without any surgical complication over the long‐term period.