There are many approaches in surgery of posterior hypopharyngeal wall cancer according to location, extent, and invasion depth of primary cancer. And many reconstruction methods have been used in reconstruction of surgical defect remaining after wide resection of primary cancer. Posterior hypopharyngeal wall cancer is relatively rare, so its surgical experiences are fewer than those of pyriform sinus cancer and there have been few reports of surgical approaches and reconstruction methods of posterior hypopharyngeal wall cancer. Recently, we experienced a case of posterior hypopharyngeal wall cancer reconstructed with longus colli flap and skin graft after failure of radial forearm free flap in a 72-year -old man and report it with the review of the literatures.