Background: In Vietnam, pyriform sinus fistula (PSF) is more common than EuropeanAmerican countries and tends to increase in frequency with abundant clinical and endoscopic features. This article analyzes all the cases of PSF patients treated at Hanoi National ENT Hospital from 2009 to 2012. Methods: Retrospective descriptive study on 324 medical records of 250 PSF patients treated at the Hanoi National ENT Hospitalfrom 2009 to 2012. Results: 137 male (54.8 percent), 113 female (45.2 percent) hospitalized 1-5 times with the mean age of 15.8 +/- 12.4 year. 81.2 percent had a history of recurrent, 25.6 percent after 1-4 operations. There are significant difference between onset and recurrent symptoms. Endoscopy found the opening tracts mainly at the bottom of pyriform sinus (87. 7 percent) and on the left (91.2 percent). Most common bacteria is streptococcus (44.64 percent). The average operative time is 121.71 +/- 36.88 minutes. Conclusion: PSF is a persistent disease, recurrentable and difficulty in treatment. Keywords: pyriform sinus fistula, recurrence.