Thirty cases of posterior pharyngeal wall carcinoma (seen in the Emory University system between 1977 and 1982) are reviewed. The study was implemented to resolve the question, "Which therapeutic alternative is preferred for the treatment of the lesion--radiation or therapy?" From our clinical experience, a treatment plan of primary surgery with postoperative radiation appears to be preferred over a treatment plan of radiation for cure with surgery held for salvage. A current review of the literature on the treatment of posterior wall carcinoma will be presented along with a review of our series.