PURPOSE OF REVIEW: Increased vocal fold hydration is a popular target in the prevention and management of voice disorders. Current intervention strategies focus on enhancing both systemic (internal) and superficial (surface) hydration. We review relevant bench and human research on the role of hydration in vocal fold physiology. RECENT FINDINGS: Bench and human studies provide converging evidence that systemic and superficial dehydration are detrimental to vocal fold physiology. Dehydration challenges increase the viscous properties of excised vocal fold tissue. Systemic, superficial, and combined drying challenges increase aerodynamic and acoustic measures of voice production in speakers. Emerging theoretical and clinical data suggest that increasing both systemic and superficial hydration levels may benefit voice production; however, robust evidence for positive outcomes of hydration treatments is lacking.