Seventeen patients underwent free jejunal autograft reconstruction of the pharyngoesophagus after ablative surgery for Stage III and IV squamous cell carcinoma of the cervical esophagus and hypopharynx. Postoperative complications included three perioperative deaths, three graft failures, six transient fistulas, and two early and one late fistula. The 5-year survival rate of patients with Stage III and IV hypopharyngeal carcinoma was 20% (one of five). The 4-year survival rate for patients with cervical esophageal carcinoma was 33% (one of three). This method of reconstruction is advocated as a reliable palliative procedure for patients with a dismal long-term survival.