PgQ is a PostgreSQL extension for implementing queues that has existed since 2007, and this talk explains why it outperforms the common SELECT FOR UPDATE SKIP LOCKED approach. The SKIP LOCKED pattern causes table bloat, dead tuples, excessive UPDATEs/DELETEs, and planner confusion. PgQ solves these problems using snapshot-based event handling, table inheritance with rotating child tables, batch processing, and a maintenance daemon (pgqd). The extension produces zero dead tuples and no write overhead on queue tables. For managed cloud Postgres services that don't natively support PgQ, it can be compiled as pure PL/pgSQL using 'make plonly', and pgqd's functionality can be replicated using pg_cron with custom wrapper procedures. The talk covers the full SQL API, internal architecture, and practical deployment strategies.