Objectives: Recently endoscopic transoral stapling (ES) of cervical (Zenker’s) diverticulum (ZD) has been reported. This abstract describes our experience with ES and compares results to our open surgical(OS) repairs for ZD. Methods: A retrospective 10 year review identified 47 patients undergoing ES or OS for ZD. ES was attempted in 28 patients and OS in 19. The only absolute requirement for ES was a ZD of at least 3cm. ES was performed transorally using a Weerdascope (extended laryngoscopy) to identify the septum between the esophagus and diverticulum. An Endostitch placed in the septum provided cephalad traction during division by a transorally placed Endo-GIA stapler. OS included myotomy alone (n=1), myotomy with diverticulopexy (n=14), or myotomy with diverticulectomy (n=4). Outcomes examined included operative time, length of stay and dysphagia severity using a scale from 1 (no dysphagia) to 5 (severe dysphagia). Results: There were 28 (59.6%) males and 19 (40%) females. ES was completed in 24/28. There were 4 conversions to OS. These 4 patients were excluded from further analysis and comparison made between the 24 successful ES and the 19 OS patients. The mean age was 76 years for the ES group and 70 years for the OS group (p=0.027). There were no deaths and only one complication in each group. Mean operative time (1.2 versus 2.4 hours.) was less (p<0.01) in the ES group. Length of stay (1.8 versus 2.4 days) was shorter for ES but not significant (P=0.13). Mean follow up was 17 (1-103) months for both groups. Dysphagia scores were comparable between the two groups preoperatively (2.71 ES versus 2.79 OS; p=0.78) and improved significantly (p=0.001) to 1.1 after ES and 1.0 after OS. The time to oral intake was 1.09 days in the ES group and 1.29 days in the OS group (p=0.36). Conclusion: ES is feasible and can be performed with shorter operative times and comparable results to OS.