Although multilevel collapse of the upper airway is not rare during sleep in patients with OSA, the velopharyngeal region is believed to be the most common site of obstruction, and lateral pharyngeal wall collapse was considered a determining factor in velopharyngeal obstruction. Consequently, palatal surgical techniques have changed throughout recent years from classic uvulopalatopharyngoplasty (UPPP) to lateral pharyngoplasty techniques. Of the different lateral pharyngoplasty techniques used, barbed reposition pharyngoplasty (BRP) has recently become one of the most practiced palatal surgery techniques in different countries. BRP was described in a pilot study by Vicini et al. in 2015, as a quick, easy, and effective technique for treating velopharyngeal obstruction in OSA patients. Authors proposed the use of the barbed suture (knotless bidirectional resorbable suture) for obtaining suspension of the palatopharyngeal muscle at the pterygomandibular raphe and expansion of the lateral walls of the oropharynx without tissue resection of the soft palate region. The effectiveness and safety of BRP have been confirmed in subsequent prospective and randomized studies.