An epiphrenic diverticulum is a pulsion diverticulum of the distal esophagus, typically within 10 cm of the gastroesophageal junction, caused by increased intraluminal pressure from an underlying motility disorder. Diagnosis is established by endoscopy, contrast esophagography, and esophageal manometry. Surgical management involves diverticulectomy with an extended myotomy to treat the motility disorder, often combined with fundoplication. Minimally invasive approaches have largely replaced open surgery, reducing morbidity and recovery time while maintaining excellent functional and anatomical outcomes.