Successful results of genioglossus advancement and hyoid myotomy with suspension (GAHM) in the treatment of obstructive sleep apnoea (OSA) have been reported. However, there have been few studies of long-term results. Forty-six patients with hypopharyngeal obstruction underwent GAHM. Patients had a mean age of 40.1 ± 4.2 years and a mean body mass index (BMI) of 28.9 ± 2.1 kg/m2. The mean follow-up was 39.4 ± 5.7 monthswith a range of 37 to 46 months. The mean pre-operative RDI, short-term RDI, and long-term RDI were 47.9 ± 8.4, 14.2 ± 3.9, 18.6 ± 4.1, respectively. The mean post-operative LSAT, short-term LSAT, and long-term LSAT were 81.2 per cent ± 2.9 per cent, 88.8 per cent ± 2.7 per cent and 87.2 per cent ± 3.1 per cent, respectively. The changein BMI was significantly different in the patients with, and without, recurrence (2.1 ± 0.3 vs 0.4 ± 0.2.kg/m2, <0.05). Thirty (65.2 per cent) patientshad long-term clinical success, and six (16.7 per cent) patients with short-term success failedlong-term. GAHM appears to be an effective procedure and results in long-term success. However,patients with weight gain are at risk of recurrence.