The techniques of intrapharyngeal surgery for obstructive sleep apnea (OSA) have evolved from radical excision of the soft tissue to functional reconstruction of the airway. This chapter aims to demonstrate the novel “palatal hybrid surgery” and its outcomes for OSA. For treating velopharyngeal obstruction in OSA patients, palatal hybrid surgery utilizes an integrated tissue-specific technique that includes mucosa preservation, tonsil excision, fat ablation, and muscle relocation/suspension. Palatal hybrid surgery can be decomposed into 1. pharyngoplasty as stereoscopic reconstruction of the lateral pharyngeal wall after tonsillectomy, 2. palatoplasty as omni-suspension of the soft palate, and 3. uvuloplasty as advancement and shortening of the uvula. The preliminary results showed its safety in no airway compromise or persistent velopharyngeal insufficiency after the surgery; the postoperative bleeding was around 2%, and postoperative pain was mild in the first week. Further, clinical symptoms (snoring and daytime sleepiness) along with polysomnographic data (apnea/hypopnea index, desaturation) improved significantly after surgery. Palatal hybrid surgery reinterprets traditional uvulopalatopharyngoplasty (UPPP) in both concept and technique, and the results showed its low morbidity and high efficacy in treating OSA patients with palatal obstruction.