The phenomenon of small voice with hoarseness may be physiological reasons or pathological reasons, such as acute laryngitis, vocal polyps or laryngeal edema. 1. Physiological reasons: some people are born with hoarse voice and have small voice due to personality reasons, which is normal and does not require special treatment. 2. Pathologic causes: (1) Acute laryngitis: due to excessive use of the voice or certain respiratory tract infections and other factors that lead to inflammation of the vocal cords, due to the pain and edema of the voice and the phenomenon of speaking in a low voice, which can also be accompanied by hoarseness, laryngeal redness and swelling and other symptoms. (2) Vocal polyps: due to the presence of translucent, white or pink swelling in the vocal folds, which can lead to the body to appear to speak in a small voice with hoarse phenomenon, and in severe cases, can also lead to loss of voice. Speaking voice small and hoarse and many other causes, it is recommended to enter the hospital in a timely manner to avoid self-judgment, blind use of medication.