<p class="abstract"><strong>Background:</strong> Upper oesophageal stenosis is a well-recognised complication in the treatment of head and neck malignancies that can result in significant morbidity. Simple strictures can be managed by anterograde dilatation. Combined approach dilatation can overcome more complex and even complete stenosis.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective analysis of prospectively gathered data for four patients who have had combined approach dilatation to overcome complete oesophageal stenosis. Outcomes determined using standardised swallowing outcome measurement tools. </p><p class="abstract"><strong>Results:</strong> A functional oesophageal lumen was restored in four patients with complete oesophageal stenosis, with a demonstrable improvement in validated swallowing outcome measures.</p><p class="abstract"><strong>Conclusions:</strong> Combined approach oesophageal dilatation can be safely and effectively utilised to overcome complete stenosis of the upper oesophagus secondary to radiotherapy/chemo-radiotherapy. Extending the indications for this procedure to post-surgical strictures is not advisable due to increased risk of serious complication.</p>