Background: Subglottic stenosis (SGS) is managed using repeated endoscopic interventions or definitive open airway reconstruction such as cricotracheal resection (CTR). While endoscopic management may reduce short-term morbidity, its impact on patient-reported quality of life compared with CTR remains unclear. This study compared airway-related quality of life and subjective voice and swallowing outcomes between patients undergoing endoscopic management and CTR for SGS. Methodology: A retrospective cohort study was performed comparing patients with SGS managed by endoscopic procedures or CTR by a single surgeon. Patient-reported outcomes were assessed using validated instruments (Dyspnoea Index, Voice Handicap Index-10, Eating Assessment Tool-10, and SGS Survey-6). Total scores were calculated according to published scoring systems and summarised as median (interquartile range). Groups were compared using Mann–Whitney U tests, with categorical comparisons performed using Fisher’s exact test. Results: Of 74 eligible patients, 50 completed outcome surveys (response rate 68%), including 32 managed endoscopically and 18 undergoing CTR. The cohort was predominantly female (CTR 94% vs endoscopic 84%) with similar median age (53.5 [IQR 43–68] vs 53.0 [IQR 47–67] years). Dyspnoea Index scores were significantly lower following CTR compared with endoscopic management (median [IQR] 2 [0–6] vs 21 [18–25], p<0.001), with fewer patients demonstrating clinically significant dyspnoea (41% vs 97%, p<0.001). Voice- and swallowing-related quality-of-life scores did not differ significantly. On SSS-6 analysis, CTR was associated with less exertional breathlessness and activity limitation (all p<0.05). Conclusion: CTR was associated with substantially improved airway-related quality of life compared with endoscopic management for SGS, without compromise in patient-reported voice or swallowing outcomes. These findings support definitive open airway reconstruction in appropriately selected patients