OBJECTIVE To study the effect and operative method of UPPP and tongue base operation for the severe OSAHS at Velo- and tongue-pharyngeal obstruction. METHODS 26 cases who were diagnosed as severe OSAHS with Velo- and tongue-pharyngeal obstruction by Muller's maneuver were treated surgically by UPPP and tongue base operation. The tongue base operation included fusiform incision or rhomboid incision in the middle of tongue base by laser or electrotome. 4 cases received tongue base lateral incision and advancement fixation. 2 cases underwent tracheotomy before the operation. 20 cases underwent tracheotomy during operation. RESULTS The 6-month, 1-year and 3-year responders are 100%, 84.6% and 76.9% respectively. The introcession of the tongue base incision were repaired in four cases. After 1-2 years, the cases with lateral incision on the tongue base with advancement fixation had temporary aspiration after the operation and recovered through practice. CONCLUSIONS The polysomnography (PSG) was essential to OSAHS and especially to severe OSAHS. Muller's maneuver is important in locating the obstructive sites of OSAHS. The stitching is essential to the cases after fusiform incision or rhomboid incision of tongue base. The combination of UPPP and tongue base operation is important for OSAHS treatment. The combined treatment of OSAHS could have a better results.