First described by Mosher in 1916, endoscopic treatment of Zenker's diverticulum has since been reported infrequently in the surgical literature and continues to engender controversy. Between 1978 and 1989, we treated 11 unselected patients surgically for pharyngoesophageal diverticula. Endoscopic diverticulotomy was used in 11 patients and an external approach was used in the others. The endoscopically treated patients had no serious complications, resumed oral intake early, and were discharged from the hospital earlier. Our review of the surgical literature confirmed our experience with the efficacy and safety of the procedure. We therefore recommend endoscopic diverticulotomy as being equal to external approaches with regard to effectiveness; and it affords the patient a shortened hospital stay and more rapid return to to the premorbid state.