Objective: To investigate the prognosis of low-temperature plasma coblation for early laryngeal cancer, and to evaluate the influence of related risk factors on DFS of patients, so as to analyze the factors affecting the surgical effect and summarize clinical experience. Methods: The clinical data of 376 patients with early laryngeal cancer who received endoscopic low temperature plasma coblation in our hospital from April 2013 to December 2020 were retrospectively analyzed. 7 patients who were lost to follow-up were excluded, and a total of 369 patients were collected. The follow-up period ranged from 32 to 124 months, with a median follow-up of 72 months. Statistical analysis was performed to obtain various oncology results, including DFS, OS, LC and LP. Results: A total of 70 patients recurred and 40 died. Overall 1-year, 2-year, and 5-year DFS for all patients were 89% (95%CI, 86%-92%), 85% (82-89%), and 80% (76%-84%), respectively, and the median DFS was not reached. The 1-year, 2-year, and 5-year overall survival OS were 97% (95%CI, 96% to 99%), 92% (89% to 95%), and 89% (85% to 92%), respectively, with the median OS not reached. ACI significantly affected DFS, but had no effect on OS. The 1-year, 2-year and 5-year DFS of ACI patients were 87% (82-92%), 82% (777-88%) and 76% (70%-82%), respectively. In non-invasive patients, 1-year, 2-year and 5-year DFS were 92% (87%-96%), 89% (84%-93%) and 85% (79%-91%), respectively. Conclusion: The efficacy of plasma coblation is comparable to that of CO2 laser surgery or radiotherapy alone. Additionally, factors such as ACI and postoperative tumor margin play a significant role in determining postoperative DFS in patients. It should be noted that secondary plasma coblation is not contraindicated for patients with postoperative recurrence. Therefore, preoperative evaluation must be conducted accordingly, and plasma coblation should only be considered when there is confirmed absence of obvious invasion of the lateral thyroid cartilage in the anterior commissuret area and attainment of a negative incisal margin before surgery, ensuring optimal therapeutic outcomes for patients.