This is an overview of the current status of minimally invasive transoral management of Zenker diverticulum. The scope is to assess whether a tailored transoral approach is feasible and safe and may improve quality of life with low recurrence rates. Over the past 30 years, significant technical changes and a shift from an open to a transoral approach have occurred in the management of Zenker diverticulum. Today, transoral stapling represents a well-established and commonly performed procedure, whereas peroral endoscopic myotomy (Z-POEM) is rapidly spreading and will probably replace most traditional therapeutic options in the near future.