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Zenker’s Diverticulum, named after Dr Friedrich Albert von Zenker (1825–1898) who in 1877 reported a series of 23 cases and first hypothesized its pathophysiology, is an uncommon pathology, occurring in elderly patients, predominantly males. It is identified by the association of dysphagia and regurgitation, and diagnosed by a barium swallow radiography with a video fluoroscopy. For a long time, it was treated only by open surgery, then by rigid endoscopy performed by ENT surgeons, despite the former’s high morbidity rate and the latter’s technical limitations. The first septotomy with a flexible endoscope was reported to have been carried out only back in 1995, by two different teams. Since then, endoscopic techniques have been adapted over the last two decades with increasing success and an increasingly higher safety profile, replacing conventional surgery as the first-line treatment, following ESGE (European Society of Gastrointestinal Endoscopy) recommendations. This mini-review aims to provide an overview of therapeutic methods with a focus on the availability of flexible endoscopy and its future progress with the advent of Z-POEM.