Optimal therapy for hypopharyngeal carcinoma depends on the stage of disease that therapy is begun. Radiotherapy and surgery get similar results for early-stage disease. For advanced-stage disease, however, radical surgery followed by radiotherapy is the treatment of choice. Extensive malignant tumors of the hypopharynx continue to challenge surgeons with respect to both type and extent of resection as well as type of reconstruction. Herein, we reported on two patients with advanced stage hypopharyngeal carcinoma who underwent extensive resection and gastric tube reconstruction. The extent of resection included the hypopharynx, larynx, cervical esophagus, and bilateral modified radical neck dissection. The gastric tube was used for alimentary tract reconstruction, and permanent tracheostomy was used for airway reconstruction. The postoperative course in both was uneventful, both regaining satisfactory ability to swallow.. One of our patients, unfortunately, died of neck recurrence ten months after operation. We conclude that reconstructing the hypopharynx with gastric tube is a reliable and safe method, though its clinical outcome depends mainly on the stage of the tumor at the time of reconstruction.