A retrospective study has been performed on 155 cases of surgically treated hypopharyngeal carcinomas in order to bring to light what effect the type of surgery has on survival and the reasons for failure. The following operations were performed: 103 hemipharyngectomies with total laryngectomy (HPTL); 28 total circular pharyngectomies with total laryngectomy (CPTL); 16 hemipharyngectomies with partial laryngectomy (HPPL); 4 exereses in lateral pharyngectomy; 2 total laryngectomies and 2 hemipharyngectomies in lateral pharyngotomy. Analysis of the results is only performed on the three most numerous groups of patients. The overall neoplastic mortality rate at 5 years was 79% for the HPTL group while it was 50% and 61% in the CPTL and HPPL groups, respectively. The actuarial survival curves show a higher, statistically significant, cumulative 5-year survival rate for the CPTL group (55.9%) than for the HPTL group (30.5%). The authors conclude that, considering the particular submucosa spreading to which hypopharyngeal carcinoma is subject and the good functional recovery which can be obtained with modern reconstructive surgery of the alimentary tract, CPTL should be the treatment of choice, even in the less advanced cases, in order to significantly reduce the risk of local recurrences.