The pharyngoplasty represents the most performed surgical technique applied in patients affected by sleep-disordered breathing (SDB), especially snoring and obstructive sleep apnea (OSA). In the last 40 years, several modification of the first uvulopharyngopalatoplasty (UPPP) has been proposed as single or combined surgical procedures. There are still multiple confounding parameters for the analysis of the pharyngoplasty outcomes. Starting from the description of the main pharyngoplasty techniques proposed in the specific literature, it will be focus the attention on the main difference between the first technique proposed by Fujita and the last techniques, remarking the importance of the right patient selection as surgical candidate. Finally, there will be introduce the technique, pit and pitfalls of the barbed pharyngoplasty, analyzing the outcome achieved and recently published as personal institutional experience.