Hypopharyngeal carcinoma often presents at an advanced stage and requires aggressive multimodal treatment. Surgery plays a crucial role both as a primary option—combined with chemotherapy and radiotherapy—and increasingly as salvage therapy. Surgical procedures frequently involve neighboring organs such as the larynx and esophagus, making the reconstructive surgeon’s role particularly vital.This round table aims to provide a comprehensive overview of the reconstructive challenges related to hypopharyngeal defects, considering orientation, shape, extent (partial or circumferential), and involvement of adjacent structures.Topics include reconstruction with free and pedicled flaps, salvage settings, and laryngeal preservation. Special focus will be given to complications, pharyngoesophageal rehabilitation, and quality of life.