Abstract Background：Recurrent respiratory papillomatosis (RRP) is recurring benign papillomatous lesions which still relies on repeated surgical treatment. However, there is no guidelines of surgical technique nowadays. Objectives: This retrospective cohort study aims to obtain a better understanding of RRP, and select the best surgical modality for RRP among microdebrider, CO2 laser and KTP laser. Study design: Retrospective cohort study. Methods: Medical records of 112 RRP patients treated at EYE&ENT Hospital of Fudan University from 2018 to 2021 were reviewed, with at least 6-month follow-up. Three treatment subgroups(microdebrider, CO2 laser and KTP laser) were analyzed within AO-RRP and JO-RRP populations respectively. Results: 112 patients (39 JO-RRP and 72 AO-RRP) and a total of 353 surgical procedures were included. Jo-RRP group had higher Derkay anatomical score(p<0.05), lower percentage of dysplasia and an earlier trend in recurrence(p<0.05) than Ao-RRP group. There were no significant differences among three surgical modalities on median treatment intervals(MTI) or survival curves(p>0.05), with the Jo-RRP MTI of the microdebrider(92.5[47.3~200]), CO2 laser(140[70~255]), KTP laser(90[62.3~221.3]), and Ao-RRP microdebrider(267.50[152.5,449.5]), CO2 laser(247.5[145.5,474.7]), KTP laser(107.5[68.3,330.5]). Conclusion and Significance: The Jo-RRP patients have more concomitant invasiveness, but less dysplasia than AO-RRP patients. Three surgical modalities appeare to be equally effective in management of Jo-RRP or AO-RRP. Key Words: Papillomatosis, surgery, treatment, recurrence, efficacy.