BACKGROUND AND OBJECTIVE: Imams are under-researched professional voice users who are exposed to significant vocal demands. This study is the first to examine the prevalence of voice impairments among Palestinian imams, addressing a critical gap in the literature and contributing to the global understanding of challenges faced by vocally intensive professions. It focuses on the functional, physical, and emotional dimensions of voice-related quality of life. SETTING AND DESIGN: A cross-sectional study using the validated Arabic version of the Voice Handicap Index-10 (VHI-10). SUBJECTS AND METHODS: Ninety participants, comprising 45 imams and 45 controls with less vocally demanding professions, were evaluated using the VHI-10. Statistical analyses, including t tests and regression analysis, were performed to identify patterns and predictors of voice handicap. RESULTS: Seventy-five percent of imams exceeded the clinical VHI-10 cutoff, indicating a high prevalence of voice handicap. The Physical dimension showed the greatest effect, while the Emotional dimension had the least. A significant correlation was observed, with years of professional experience predicting lower Total VHI-10 scores (B = -0.41, R² = 0.95, P <
0.001), whereas education level had no significant effect (P >
0.05). Analyses of variance revealed significant effects of professional experience on the Physical subscale (P <
0.001), but not on the Emotional subscale (P >
0.05). CONCLUSION: Palestinian imams face significant voice handicap, primarily driven by physical strain. Professional experience appears to mitigate its severity. These findings underline the need for culturally tailored, evidence-based interventions for this population, including vocal training and voice hygiene programs.