This article introduces the pathogenesis and relevant anatomy of Zenker diverticulum. The clinical symptoms and relevant investigation are presented along with the various therapeutic interventions including open and endoscopic approaches. Techniques to perform the myotomy and diverticulectomy are expanded on and include traditional suture ligation, endoscopic stapling devices, microlaryngoscopic CO2 laser and flexible LISA laser. The article concludes with a management algorithm for this entity based on the size of the diverticulum.