Study aim: The aim of this retrospective, nonrandomized study was to compare the results of diverticulectomy and diverticulopexy in the treatment of Zenker's diverticulum. Over the 10-year period between 1988 and 1998, surgery for Zenker's diverticulum was performed in 40 patients. Patients and method: The study group consisted of 23 men and 17 women with a mean age of 72 years. Only 39 patients were evaluated in 19 patients, treatment consisted of cricopharyngeal myotomy and diverticulum suspension, in the ether 19 patients, treatment consisted of diverticulectomy in addition to myotomy. Only one patient had a diverticulectomy without myotomy. Results: There was no mortality and the morbidity rate was low: one fistula one pneumonia, three cases of transient dysphonia and one hematoma. The results were excellent in 35 patients, and good in 3 patients. Conclusion: Cricopharyngeal myotomy with diverticulopexy is particularly suitable for geriatric patients, Diverticulectomy is proposed in the case of a diverticulum larger than 6 cm and for young patients to prevent the risk of malignant transformation. (C) 2001 Editions scientifiques at medicales Elsevier SAS.