Congenital pyriform sinus fistula(CPSF) is a rare brancial cleft deformity in neck,characterized by acute suppurative thyroiditis,recurrent cervical abscesses and cellulitis.At present,surgical treatment of CPSF include traditional surgery and endoscopic cauterization.In the past,en block resection of the fistula by surgery is the only cure method.The late 90,relatively safe and effective endoscopic and minimally invasive aesthetic surgery is applied in treatment of CPSF,and was recommended as the preferred treatment for congenital pyriform sinus fistula.From the long-term efficacy,which method is more dominant,yet to be elegant.Through the analysis of embryo principles and anatomy of CPSF,we introduce and summarize the indications,complications and prevention in conventional surgical treatment and endoscopic cauterization,and briefly descript the factors influencing the efficacy of the treatment of CPSF.