Glottic cancer accounts for 70% of the laryngeal cancer, and lymph node metastasis is rare. Early glottic cancer often causes hoarseness, which is easy to detect early in the process of treatment and has the best prognosis of all laryngeal cancers. In the past 10 years, the guidelines of the National Comprehensive Cancer Network (NCCN) in the United States on the diagnosis and treatment of early glottic cancer have been updated more than 20 times, and the treatment mode of transoral CO₂ laser microsurgery or radiotherapy alone has gradually formed. Laryngeal preservation and voice quality are key factors in measuring the success of treatment. At present, there are fewer and fewer open surgeries, and the question of whether transoral CO₂ laser microsurgery or radiotherapy alone is the preferred treatment option has been unresolved. This article introduces the progress of early glottic cancer treatment and the key points of personalized treatment selection, and summarizes the prognostic factors affecting tumor recurrence and the biomarkers for predicting recurrence, in order to provide clinical reference for guiding the treatment and follow-up of early glottic cancer patients.