The pharyngoesophageal or Zenker diverticulum is the most common diverticulum of the esophagus and is typically located posteriorly on the left side of the neck. It is a pulsion or false diverticulum resulting from incoordination of cricopharyngeal function. Patients frequently present with dysphasia, a gurgling sound when swallowing liquids, or regurgitation of food. A large diverticulum may be diagnosed by a plain neck x-ray film showing an air-fluid level, but more frequently the diagnosis is made by a barium swallow study. The use of ultrasound for making this diagnosis has been reported in patients with symptomatic large diverticula.1,2 Treatment usually requires cervical esophagomyotomy and diverticulectomy.