Elite professional voice users experience a high vocal load and if voice quality deteriorates, their livelihoods are affected. Our aim was to assess how an elite professional voice user group, musical theater students (n=49), perceive their voices in comparison with medical students (n=43).Cross-sectional study.Participants completed a confidential questionnaire including demographics and the Voice Handicap Index-10 (VHI-10) in September 2010.Response rate was 100% (92/92). The mean age of the medical students was 25 years and of musical theater students was 20 years. The mean overall VHI-10 score was higher in musical theater students compared with that of medical students (mean score, 5.56 and standard deviation [SD], 4.13 vs mean score, 3.79 and SD, 3.02, P=0.02), particularly in three VHI-10 items: voice strain, lack of clarity, and being upset from voice problem (mean score, 0.82 and SD, 0.86 vs mean score, 0.44 and SD, 0.67, P=0.02; mean score, 0.92 and SD, 0.89 vs mean score, 0.53 and SD, 0.70, P=0.02; and mean score, 0.49 and SD, 0.79 vs mean score, 0.07 and SD, 0.26, P=0.001, respectively). Furthermore, musical theater students report higher possible voice problems in the past (6/43 [14%], 21/49 [43%], P=0.002).In this small group, musical theater students report more handicap compared with medical students. It is possible that this difference may be because of the musical theater students experiencing greater voice use over time or better recognition of potential voice problems. This may mean that we need to do more to protect student's voices by optimizing vocal care during their training, without neglecting the vocal needs of other students.