The patient was a 60 year old white male who complained of the production of an embarrassing gurgling noise and dysphagia, and of aspiration of saliva during sleep. Barium swallow revealed a giant Zenker's diverticulum that descended down into the mediastinum to the level of the aortic arch. Diverticulectomy with cricopharyngeal myotomy was carried out through an oblique incision on the left side of the neck. The diverticulum was withdrawn from the mediastinum without difficulty by blunt dissection.