We studied 69 hypopharyngeal cancer patients who were treated between 1979 and 1992. The 5-year cumulative survival rate was 53%. There were five stage I, seven stage II, 20 stage III and 37 stage IV patients; survival rates for stages I, II, III, and IV were 80%, 54%, 61% and 47%, respectively. The 5-year survival rate for the 25 patients who received preoperative radiotherapy (fewer than 40 Gy) followed by total pharyngo-laryngo-esophagectomy was 59%. Forty-four patients received radical radiotherapy as a main treatment. From the standpoint of preserving vocal function, we recommend using the radical radiation as a first-choice treatment. The 5-year survival rate was 48%. There were 16 radiation failure patients after radical radiotherapy and two of them refused to have surgery. Fourteen patients (36%) received a salvage operation and the survival rate was 36%. The survival rate for the 30 patients who did not receive surgery was 61%; the patients who received surgery as a palliative purpose and the patients who refused to undergo surgery were included in this group. Both treatment regimens of the present study showed higher survival rates compared to the results of previous studies. We concluded that the improved results were due to the proper selection of the treatment, especially the attention given to the patient's immune response and the minimum death as a result of neck node metastasis.