[1][2] When there is excessive pressure within the lower pharynx, the weakest portion of the pharyngeal wall balloons out, forming a diverticulum which may reach several centimetres in diameter.

While traction and pulsion mechanisms have long been deemed the main factors promoting development of a Zenker's diverticulum, current consensus considers occlusive mechanisms to be most important: uncoordinated swallowing, impaired relaxation and spasm of the cricopharyngeus muscle lead to an increase in pressure within the distal pharynx, so that its wall herniates through the point of least resistance (known as Killian's triangle, located superior to the cricopharyngeus muscle and inferior to the thyropharyngeus muscle.

[3] While it may be asymptomatic, Zenker diverticulum can present with the following symptoms: It rarely, if ever, causes any pain.

Killian's diverticulum is formed in the Killian-Jamiseon triangle (between the oblique and transverse fibers of the cricopharyngeus muscle).

[8] Other non-surgical treatment modalities also exist, such as endoscopic laser, which recent evidence suggests is less effective than stapling.