Synovial sarcoma (SS) is a malignant mesenchymal neoplasm usually involving the lower limbs of young adults. Localization in head-neck district is rare. Histologically, these are characterised by a biphasic or monophasic variant, the latter being more rare and difficult to identify. Immunohistochemistry plays a crucial role in the diagnosis. Cytogenetics also play an important role since both the monophasic and the biphasic forms are characterised by a reciprocal translocation (x;18) (p 11.2;q 11.2). Treatment options include an aggressive surgical approach and radiotherapy, whereas the role of chemotherapy remains to be defined. The case is described of monophasic synovial sarcoma located in the hypopharynx and a review is made of the literature concerning this rare neoplasm.