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Introduction: Zenker’s diverticula (ZD) are associated with a wide range of symptoms such as dysphagia, regurgitation of undigested food and halitosis. It is believed that ZD are formed through pulsion forces in a weak area of the hypopharyngeal wall. Poor upper esophageal sphincter (UES) compliance is the presumed pathophysiologic mechanism, yet, the underlying pathophysiology is still unknown. This study aimed to characterize pharyngo-esophageal function in ZD patients using high resolution manometry with impedance (HRIM) Material & Methods: 21 ZD patients (14M, 70±10 yrs) and 48 healthy adults (18M, 51±17 yrs) were included. All patients had HRIM pre-surgery (myotomy and pexy) and 5 patients post-surgery. Swallow Gateway™ analysis (swallowgateway.com) was used to analyze the recordings and determine metrics of pharyngeal function for 10ml liquid swallows. Results: Compared to controls, patients had increased swallow dysfunction (SRI), intrabolus distention pressures (IBP), UES and pharyngeal contractile pressures (UESCI, PhCI); and decreased UES relaxation (UES IRP), opening time (UES Open Time) and aberrant flow timing (DCL). All pre-surgery patients had reduced opening extent (UES Max Adm) due to impaired relaxation (20/21), low distention pressures (4/21) or low pharyngeal contractility (9/16). 4/21 patients aspirated. Basal UES pressure was not altered in pre- or post-surgery patients compared to controls. Conclusions: ZD patients demonstrate altered swallowing biomechanics consistent with obstructive pathology. In the subgroup of patients assessed post-operatively the biomechanical measures remained consistent with structural pathology.