On an average 35%, of the carcinomas of the pharynx are localized in the hypopharynx. 44 carcinomas of the hypopharynx were analyzed which were observed 1970-1979 in the Institute of Pathology of the University of Hamburg. The age peak lays in the 7th decade of age. 84% of the patients were male. 68% of the cases were localized in the sinus piriformis, 21% in the posterior wall and 11% in the post-cricoid area. The stage T4 of the TNM classification existed in 87% of the cases, a formation of hematic pulmonary metastases in 40%. The highest frequency of metastases if found in the carcinomas of the sinus piriformis. According to the WHO classification 91% of the carcinomas were squamous cell carcinomas and 9% anaplastic carcinomas. 9% of the squamous cell carcinomas were high differentiated, 52% moderate and 30% poor differentiated. A very distinct stromal reaction was observed in the high differentiated carcinomas. The plasma cells showed a high content of IgA and IgG as revealed by the application of the indirect immunoperoxidase method. The content of Ig-containing plasma cells is distinctly reduced in poor differentiated carcinomas or after radiation therapy. A positive marking of carcinoembryonic antigen could be demonstrated in high and moderate differentiated carcinomas, especially in the keratinized areas. Prestages of the carcinomas are leukoplakias with dysplasia and papillomas, early stages the carcinoma in situ. Risk factors are tobacco abuse, alcoholism and the Plummer-Vinson's syndrome.