The cricopharyngeal diverticulum or Zenker's diverticulum is the most frequent type of diverticulum of the upper gastrointestinal tract. It occurs mostly in elderly patients. The predominant symptoms are dysphagia and regurgitation which may result in malnutrition and aspiration pneumonia, the latter eventually being life threatening. The underlying cause of Zenker's diverticulum is a dysfunction of the cricopharyngeal muscle and the upper esophageal sphincter, the most common finding being a decreased compliance. The treatment consists in a myotomy of the upper esophageal sphincter and cricopharyngeal muscle combined with a diverticulopexy or diverticulectomy. This procedure is performed via a limited left cervicotomy. Results are excellent to very good in 94% of the patients in our own experience.