During a 25-year period, nineteen patients with esophageal diverticulum were treated surgically in PUMC Hospital. Of them, eleven cases underwent resection of the diverticulum (10 pulsion type and 1 traction type); and four cases were treated by inversion suturing of the diverticulum (all traction type). The results of follow-up showed that pulsion diverticulum resection was satisfactory, and the resection was better than inversion suturing for traction-type diverticula. In this series, diverticulitis and esophagitis were present in all cases. Carcinoma of the esophagus developed at site near the diverticulum in 4 cases. Pathologic examination demonstrated severe submucosal inflammatory infiltration and epithelial hyperplasia of the esophagus associated with the diverticulum, with these changes being increasingly severe with the precondition of the carcinoma to the diverticulum. Carcinoma of the esophagus as a complication of diverticulum may be associated with chronic diverticulitis and esophagitis.