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Introduction: Zenker's diverticulum is a protrusion of the pharyngeal mucosa through Killian's triangle. It is a rare pathology, but of great importance since it compromises the quality of life of patients who suffer from it. In addition, it can be treated by different methods which have been evolving over the years, but at the moment applying them to each patient, each one has its own advantages and disadvantages, so these should be evaluated with caution, individually according to each case requires it. Materials and Methods: A narrative review was carried out, using databases such as Scielo, PubMed, Science direct, academic google. A search for articles in indexed journals in English and Spanish was carried out from 2010 to 2021. Results: In the management of Zenker's diverticulum there are several methods, endoscopic approach and open technique, currently the endoscopic approach is preferred over the external one. Although the open technique has been more studied and the endoscopic one represents a challenge that requires the expertise of the professional who performs it, surgeons prefer endoscopic techniques since they are minimally invasive and are believed to cause fewer complications. Also, they produce results similar to classic Tran’s cervical repair. Conclusion: The open technique is a more definitive and immediate method that relieves symptoms and prevents recurrence. The endoscopy technique is shorter, it avoids recurrence, but the results are highly variable in each patient.