Objective?To investigate the clinical efficacy of microlaryngoscopy radiofrequency in treatment of patients with tongue base cysts. Methods 42 patients with tongue base cysts from January 2013 to December 2014 were randomly divided into treatment group and control group, the treatment group underwent microlaryngoscopy radiofrequency treatment, the control group underwent direct laryngoscopy under the tongue cystectomy, then the operation time, blood loss and postoperative recurrence rate were observed and recorded, and self-evaluation method using visual analog (VAS) to evaluate the effect of surgery. Results The operative time of treatment group was significantly shorter, and the blood loss was significantly less than the control group, the difference between the two groups was statistically significant (P < 0.01); for 1-year follow-up, six-month recurrence rate in control group was 9.52%, the treatment group had no recurrence cases, the difference was not statistically significant (P > 0.05); 12 months, the recurrence rate was 28.57% in the control group, the treatment group, the recurrence rate was 4.76%, the difference between the two groups was statistically significant (P < 0.05); Preoperative VAS score of the two groups have no significant difference, while after surgery, the VAS scores' difference was statistically significant, even treatment group compared with the control group VAS scores after surgery was statistically significant (P < 0.01). Conclusion Microlaryngoscopy radiofrequency in treatment of tongue base cysts have advantages of significant efficacy, safe and reliable, It's worthy of clinical promoting.