Vallecular pseudodiverticulum following laryngectomy may be responsible for dysphagia if large enough to compress the cervical esophagus. The pouch probably represents a defect caused by the antagonistic action of tongue and inferior constrictor muscles in laryngectomy repair. Initially, the pocket may remain limited or may form a pharyngocutaneous fistulous tract. Two laryngectomy patients who developed a large vallecular pseudodiverticulum were sufficiently symptomatic to require surgical management. An external approach was used successfully to resect the party wall between the diverticulum and the cervical esophagus.