Background: In Vietnam, pyriform sinus fistula (PSF) is more common than European-American countries and the unique treatment method so far is surgical removal of the entire fistula tract. However, the recurrence rate is still high. Applications internal opening tract closure method in treatment has been achieving encouraging results. Methods: prospective study, along follow-up with intervention. Results: From August 2013 to August 2014, 58 PSF patients (33 male, 25 female) were selected 68.96 percent patients are onset 10 years of age. 36 patients had a history of recurrent (15 after radical treatments). Common symptoms of recurrence are neck pain (88. 89 percent), fever (55.56 percent) due to neck side inflammation or abscess (80.55 percent). Endoscopy found the opening tracts mainly at the bottom of pyriform sinus (33/36 patients) and on the left (32/36 patients). Treatment by internal opening tract closure method for 55 patients (surgery for 45 patients and electricauterization for 10 patients. Mean time surgery: 86.7 and 23.0 minutes. Recurrent rate: 0 percent. Conclusion: Internal opening tract closure is a method which has great potential to success.