ObjectiveSTo analyze the survival outcomes of patients with locally advanced hypopharyngeal squamous cell carcinoma (HPSCC) treated with surgery combined with concurrent chemoradiotherapy (CCRT), and to explore the factors influencing their survival. MethodsSThis retrospective study enrolled 152 patients with locally advanced HPSCC who received surgery combined with CCRT at the First Affiliated Hospital of Xinjiang Medical University from January 2012 to June 2022. All patients were followed up continuously after surgery, with the last follow-up date set as June 30, 2025. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Clinical data including age, gender, tumor location, clinical stage, TNM stage, and pathological differentiation were collected. Kaplan-Meier method and Log-Rank test were used to analyze the correlations between these factors and OS/PFS, while Cox proportional hazards regression model was applied to identify independent factors affecting OS and PFS in these patients. ResultsSThe mean age of the enrolled patients was (61.20±9.65) years, with a median follow-up duration of 42 (24, 59) months. Among them, 80 (52.6%) patients died, and among the 72 surviving patients, 53 (73.6%) had no disease progression, while 19 (26.4%) experienced disease progression. The median OS and PFS after treatment were 51.0 months (95%CI: 40.5-61.5) and 44.0 months (95%CI: 38.5-49.5), respectively. The 1-year, 3-year, and 5-year OS rates were 92.1%, 66.8%, and 40.6%, while the corresponding PFS rates were 91.4%, 58.1%, and 32.5%. Kaplan-Meier and Log-Rank analyses showed that OS and PFS significantly differed by age, T stage, N stage, clinical stage, and pathological differentiation (all P<0.05). Multivariate Cox regression indicated that older age, T3 stage, N1 stage, clinical stage III, and poor differentiation were independent risk factors for reduced OS and PFS (all P<0.05). ConclusionSIncreased age, advanced T stage, N stage, clinical stage, and poor pathological differentiation are associated with significantly higher risks of death and disease progression in patients with locally advanced HPSCC treated with surgery combined with concurrent chemoradiotherapy.