On the basis of a literature review of the last 20 years concerning the surgical and/or radiotherapeutic management of hypopharyngeal carcinoma (and in particular, pyriform sinus carcinoma), the indications for therapy are presented and the results of loco-regional control, organ preservation, quality of life and complications analyzed critically. Using this material and in the following publications, the applications of chemotherapy and its results in treatment are discussed. The concept of minimally invasive therapy is presented, especially as it involves transoral function preservation laser microsurgery and its long-term results.