Esophageal diverticula are extremely rare disease. Diverticulectomy with myotomy and partial or total fundoplication is recommended as surgical treatment: the aim of this combined procedure is to control esophageal motility disorder symptoms and to prevent reflux. We present a case of a 69-year-old man admitted in Intensive Care Unit (ICU) for aspiration pneumonia with severe dyspnea and cyanosis complicated by neurological troubles. Since 3 months he suffered from regurgitation, dysphagia, recurrent nausea and vomiting, limiting his daily lifestyle. Moreover a weight loss of 5 kilos in 3 months were associated. A Barium study revealed a 4 cm epiphrenic oesophageal diverticulum (EED) and confirmed by upper endoscopy. A surgery was planned. A laparoscopic approach with 4 trocars (12 mm trocars in the left upper quadrant, two 5 mm trocar in the right paramedian quadrant and epigastric region, and the camera port inserted directly above the umbilicus). The abdominal and lower mediastinal segments of the esophagus are mobilized. Then the diverticulum is dissected with a linear stapler reinforced with an hemostatic patch. After the diverticulectomy, a Heller esophagocardiomyotomy is performed for a 6 cm segment and then completed with a Nissen fundoplication. Histopathologic examination of the specimen showed an inflamed diverticulum without any malignant findings. Post-operative course was uneventful. Patient was discharged in post-operative day 6 and we performed a barium study one month later that was normal.