The relatively new technique of endoscopic stapling in the surgical management of pharyngeal pouch has gained widespread popularity over the last few years. The technique seems to be the procedure of choice as it is easier and quicker to perform and has a lower morbidity compared with open techniques. We present here an overview of the current evidence provided by a literature search performed by Ovid MEDLINE on literature published between January 1993 and May 2003 on endoscopic stapling of pharyngeal pouch. Several case series have been reported on various aspects of the surgery. The modifications in technique, peri-operative care, success rate, complications and recurrence are summarized, based on observational analytical case series. There were no randomized controlled trials comparing this approach to any other endoscopic or open surgical techniques for pharyngeal pouch.