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This is a prospective, multi-institutional long-term study comparing the outcomes of open and endoscopic treatment, which have not been done yet. The purpose of this study is to compare the effectiveness of surgical procedures (between endoscopic and open transcervical approach) for Zenker's esophageal diverticulum using pre-operative and post-operative assessment of symptoms and to satisfy the patients in order to determine whether demographics such as age, pre-operative size, and/or peri-operative co-morbidities influence outcomes. The study will help to learn more about common treatments for Zenker's diverticulum (esophageal pouches), how well they work, and how this disease affects the quality of your life.