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Objectives: To investigate the prevalence of left vocal cord paralysis (LVCP) after neonatal patent ductus arteriosus (PDA) surgery in young adults born extremely preterm (EP i.e. Methods: All subjects in a nationwide cohort of young adults born EP/ELBW during 99-00 who had a history of neonatal PDA surgery were invited to undergo examination with laryngoscopy, vocal cord stroboscopy, spirometry and continuous laryngoscopy during maximal treadmill exercise. Results: Thirty (63%) of 48 eligible subjects were examined at mean (standard deviation (SD)) age 19.4 (0.8) years. Mean birthweight was 792 (178) g and median (range) gestational age was 26 (23-29) weeks. Sixteen (53%) participants were diagnosed with LVCP, including two with additional laryngeal pathology, three (10%) had other laryngeal pathology, and 11 (37%) had a normal larynx. Mean (95% confidence interval (CI)) z-score for forced expiratory volume in 1 second was -1.8 (-2.5 to -1.0) in the group with LVCP and -1.5 (-2.6 to -0.4) in the group with normal larynx. Mean (95% CI) peak oxygen consumption (%predicted) was 80 (68 to 92) % in the group with isolated LVCP and 79 (75 to 84.0) % in the group with normal larynx. Conclusions: LVCP was common in young adult exposed to neonatal PDA surgery as EP/ELBW infants. Aerobic capacity and lung function were reduced in both groups, but seemingly not influenced by LVCP.