The results of surgical treatment and causes of failure in 109 patients with squamous cell carcinoma of the hypopharynx were analyzed. The 5-year survival was significantly related to the stage of the disease (stage I, 74%; stage II, 63%; stage 111, 32%; and stage IV, 14%) and the preoperative nodal staging (NO, 57%; N1, 28%; N2, 6%; and N3, OYo), but not related to the extent of tumor resection The local control rate was 86% and the majority of the local recurrences occurred at the upper resection margin. There was no significant difference in the local recurrence rate between those patients who had pharyngolaryngoesophagectomy and ,[hose who had pharyngolaryngectomy. However, the resection-associated complications (bleeding, cardiac arrhythmia., pulmonary complications) were more frequent when total esophagectomy was performed. Reconstructionassociated complications such as wound infection and anastomotic leakage occurred less often after gastric pull-up reconstruction as compared with the use of myocutaneous flap, but was associated with more serious outcome after pharyngogastric anastomosis. Thirty-seven patients (34%) had neck node recurrences and these were significantly related to the preoperative nodal staging (NO. 20%; N1, 37%; N2, 48%; and N3, 83%).