On occasions, for reconstruction after oesophagectomy, an anastomosis in the neck will be required. Our unit has a series of more than 900 cases where, following oesophagectomy, a neck anastomosis was required. From 1993 to 2017, there were 680 patients with a gastric pullup and neck anastomosis. Anastomotic leak occurred in 73 patients (10.7%): grade 1, 9.8%; grade 2, 0.7%; grade 3, 0.1% (required surgical intervention). The vocal cord palsy rate (transient) was 2%. The presentation will include a video outlining the steps for the approach to the oesophagus in the neck, transfer of the conduit to the neck, and completion of an anastomosis. Tips related to each step will be presented along with an overview of the changes that have occurred over time.