A review of patients who had surgery for Zenker's diverticulum in our institution in recent years was conducted. A comparison of inversion versus excision of the sac shows that inversion carries lower morbidity and more rapid rehabilitation of swallowing than does excision. Inversion (plus cricopharyngeal myotomy) is to be preferred for diverticula that are neither too large to invert nor too longstanding to risk leaving subclinical carcinoma behind in the wall of the diverticulum.