Augmentation pharyngoplasty is a surgical approach to treat velopharyngeal dysfunction (VPD). This technique refers primarily to the building up or addition of material to the posterior pharynx to improve velopharyngeal competency for speech or swallowing. Individuals with a history of congenital or acquired velopharyngeal insufficiency are potential candidates for augmentation pharyngoplasty. In addition, individuals who experience stress VPD when singing or playing a wind instrument are often excellent candidates to undergo augmentation pharyngoplasty. Both exogenous and autologous materials may be implanted or injected. This chapter reviews the existing state of augmentation pharyngoplasty as published in the medical literature, with particular attention to the range of tissue fillers or implants available, patient candidacy, and speech and swallowing outcomes.