Improving the pharyngeal stage of swallowing while preserving the laryngeal function is usually the most important goal of surgical treatment for the patients with severe dysphagia. To date, many surgical procedures have been introduced to allow patients to resume oral intake and thereby improve the patient’s quality of life. Typical surgical procedures include cricopharyngeal myotomy, laryngeal suspension, type I thyroplasty, arytenoid adduction, injection laryngoplasty, and pharyngeal flap surgery, etc. Considering the increasing number of patients with dysphagia in an aging society in recent years, otolaryngologists should therefore be knowledgeable of as many surgical procedures as possible. However, since surgery is not indicated for all patients with pharyngeal stage dysphagia, the pathological conditions of dysphagia should be properly understood based on the patient’s physical, mental and social backgrounds. According to each surgical principle and indication, it is necessary to perform one or more appropriate surgical procedures.