Congenital, neuromuscular and motor abnormalities of the pharynx, esophagus and diaphragm, coupled with intra- and extraluminal factors, play roles in the pathogenesis of esophageal diverticula. Principal presenting symptoms are regurgitation, obstruction, aspiration, pneumonitis and esophagitis. Cineradiography and manometry are useful methods of evaluation. Treatment, which may be simple excision or myotomy, does not correct the basic motor abnormality that is often associated with the diverticulum.