Introduction: Hypopharyngeal squamous cell carcinoma (HPSCC) is generally managed with multimodal therapy. After curative treatment, patients undergo surveillance with clinical examinations and imaging; however, evidence to guide the optimal intensity and timing of follow-up remains limited. Although the National Comprehensive Cancer Network guidelines state that most recurrences occur within 2 years after treatment, large-scale studies specifically evaluating recurrence timing in HPSCC are lacking. We therefore analyzed recurrence timing and patterns using a Japanese national database. Material and Methods: We analyzed 7,950 patients with HPSCC included in the 5-year follow-up report of the Japan Head and Neck Cancer Society National Registry for cases registered between 2011 and 2016. Five-year cumulative incidences of overall recurrence, local recurrence, nodal recurrence, and distant metastasis were calculated according to clinical stage. Results: Advanced disease (clinical stage III or higher) accounted for 66% of cases. The 5-year cumulative overall recurrence rates for clinical stages I, II, III, IVA, and IVB were 17.4%, 27.3%, 35.8%, 50.3%, and 68.7%, respectively. The corresponding local recurrence rates were 9.3%, 13.3%, 12.1%, 11.2%, and 15.6%; nodal recurrence rates were 6.5%, 9.3%, 13.6%, 16.3%, and 14.5%; and distant metastasis rates were 1.4%, 4.0%, 7.8%, 22.2%, and 26.2%, respectively. Recurrence was relatively gradual in stages I-II, whereas approximately 80% of recurrences in stage III and more than 85% in stages IVA-IVB occurred within 2 years after treatment. Conclusions: This Japanese national database study demonstrated clear stage-dependent differences in recurrence timing and patterns in HPSCC. Recurrence was concentrated within the first 2 years in advanced-stage disease, whereas it was more evenly distributed over time in early-stage disease. These findings may help refine post-treatment surveillance strategies.