Surgical correction of palatal obstruction is frequently needed as part of the multilevel treatment of moderate and severe obstructive sleep apnea/hypopnea syndrome. The classic uvulopalatopharyngoplasty technique described by Fujita has limited success rates. Uvulopalatopharyngoplasty has been modified in the form of Z-palatoplasty. Although this technique was first described for patients without tonsils, it has been further modified to include tonsillectomy along with pharyngoplasty. We describe the author's technique and experience with this new modification.