Hypopharyngeal cancer usually has invasiveness to adjacent tissue and frequent metastasis to cervical lymph node. In addition, because it often accompanies submucosal extension and second primary malignancy, the sacrifice of larynx and postoperative radiation therapy had been performed in the past. However, it has been reported that conservative surgery of hypopharyngeal cancer show good functional and oncologic outcome according to the development of diagnostic tool and reconstructive technique. We report a case of hypopharyngeal cancer that received conservative surgery followed radiation therapy and intraoperative radiation therapy for neck recurrence.