OBJECTIVE Little is known about the efficacy of using artificial intelligence to identify laryngeal carcinoma from images of vocal lesions taken in different hospitals with multiple laryngoscope systems. This multicenter study was aimed to establish an artificial intelligence system and provide a reliable auxiliary tool to screen for laryngeal carcinoma. Study Design: Multicentre case-control study Setting: Six tertiary care centers Participants: The laryngoscopy images were collected from 2179 patients with vocal lesions. Outcome Measures: An automatic detection system of laryngeal carcinoma was established based on Faster R-CNN, which was used to distinguish vocal malignant and benign lesions in 2179 laryngoscopy images acquired from 6 hospitals with 5 types of laryngoscopy systems. Pathology was the gold standard to identify malignant and benign vocal lesions. Results: Among 89 cases of the malignant group, the classifier was able to evaluate the laryngeal carcinoma in 66 patients (74.16%, sensitivity), while the classifier was able to assess the benign laryngeal lesion in 503 cases among 640 cases of the benign group (78.59%, specificity). Furthermore, the CNN-based classifier achieved an overall accuracy of 78.05% with a 95.63% negative prediction for the testing dataset. Conclusion: This automatic diagnostic system has the potential to assist clinical laryngeal carcinoma diagnosis, which may improve and standardize the diagnostic capacity of endoscopists using different laryngoscopes.