Obstructive sleep apnea (OSA) is a disease impacting up to 20% of our population. It causes significant issues with the patient’s quality of life and confers increased risk of cardiovascular comorbidities. Positive airway pressure (PAP) is a typical initial treatment option for management of OSA. However, many patients struggle with compliance with this intervention. Motivated by the tremendous number of patients struggling with PAP therapy, alternative treatment options have been developed. The original derivation of the uvulopalatopharyngoplasty (UPPP) was described by Fujita in 1981. This was a huge advance in management of OSA as it offered an alternative to many patients and spurred the development of other management strategies. However, the traditional UPPP was plagued by limited effectiveness and unwanted surgical side effects. Since the development of the UPPP, newer techniques have been created to address soft tissue collapse at the level of the velum and lateral oropharyngeal walls. These include expansion sphincter pharyngoplasty, lateral pharyngoplasty, barbed suture pharyngoplasty, among others. These techniques have shown improved efficacy over traditional UPPP and have been used in conjunction with upper airway stimulation (UAS) to optimize patient candidacy or improve outcomes in non-responders to stimulation therapy. UAS is a treatment option for select patients with OSA that selectively stimulates the medial branches of the hypoglossal nerve which innervate the genioglossus muscle, leading to tongue contraction and protrusion. The goals of the session are to utilize brief lecture and case-based discussions to highlight the advanced lateral palatopharyngoplasty techniques. We will discuss the physical exam and diagnostic criterial used to select specific procedures and the steps involved in performing these procedures. We will also discuss the role of these techniques in converting patients with concentric collapse at the velum into candidates for UAS and their utility as a rescue procedure for those undergoing UAS with residual OSA.