On the basis of 20 years' experience, the authors present the immediate and long-term results of operative treatment of Zenker's diverticulum. Comparison of two methods of surgery--diverticulopexia (in 21 patients) and excision (in 16), both associated with upper esophageal sphincter myotomy--shows good immediate and long-term results (from 1 to 19 years), with disappearance of symptoms (dysphagia) in all patients. There was no perioperative mortality. Postoperative complications were most commonly of pulmonary origin and were observed in a third of patients in both groups. In two patients from the group treated with excision, a leak from the suture line occurred, which healed spontaneously. These two patients had transient dysphagia in the postoperative period. On the basis of this analysis, the authors conclude that diverticulopexia is a safer surgical procedure than excision, giving less complications and a very good long-term functional result.