The objective of the present study was to analyse current concepts of etiology, pathogenesis, and clinical picture in conjunction with current approaches to the treatment of parapharyngitis and its complications of tonsillar genesis. The secondary objective was to enhance the effectiveness of diagnostics and management of this condition. A total of 68 patients presenting with parapharyngitis were admitted to the otorhinlaryinological clinic of the Moscow Regional Research Clinical Institute during the period from 1998 to 2012. Fifty three of them suffered acute suppurative inflammation in the parapharyngeal region that developed as a result of paratonsillar abscess. The suppurative inflammation of the parapharyngeal space was most frequently associated with abscess formation (n=59). It occurred much rarerly (n=7) as diffuse phlegmon. All seven patients with this pathology of cervical localization developed it in association with paratonsillar abscess. Moreover, five of them suffered paratonsillar abscess. These patients underwent lancing and drainage of cervical phlegmon, besides abscess-tonsillectomy. Five of the patients with cervical phlegmon developed mediastinitis, and three of them died despite abscess-tonsillectomy, lancing and drainage of the region surrounding the tumour in combination with bilateral collar mediastinotomy. In all the remaining cases, the favourable outcome was achieved. Despite a wide spectrum of currently available pharmaceutical products for the treatment of etiological precursors of the above disorders, the rate of complications remains rather high which requires thorough attention to be given to this problem as well as its good knowledge and training the personal for the purpose of opportune diagnostics and adequate treatment of the diseases.