Glottic cancer accounts for 70% of the incidence of laryngeal cancer, and lymph node metastasis is rare. Early glottic cancer (EGC) often causes hoarseness, which is easy to detect early during presentation and has the best prognosis of all laryngeal cancers. In the past 10 years, the NCCN guidelines have been updated more than 20 times on the diagnosis and treatment of EGC, and the treatment mode of transoral CO2 laser microsurgery (TLM) or radiotherapy alone has gradually formed. Laryngeal preservation and voice quality are key factors in measuring the success of EGC therapy, and with fewer open surgeries, the question of whether TLM or RT is preferred remains open. This article introduces the progress of EGC treatment and the key points of personalized treatment selection, and summarizes the prognostic factors affecting tumor recurrence and the biomarkers that predict recurrence, in order to provide clinical reference for the treatment and follow-up of EGC patients.