Achalasia of the esophagus is characterized by lack of neuromuscular coordination, which results in an absence of normal peristalsis in the body of the esophagus and a failure of relaxation of the lower segment. It is a frequent cause of esophageal obstruction. Symptoms of achalasia include dysphagia, regurgitation (nocturnal overflow), substernal discomfort, recurrent pulmonary infection, and weight loss. The diagnosis of achalasia is established by esophagoscopy, x-ray examinations (routine posterioanterior and lateral views), barium swallow and cinefluoroscopy, and esophageal motility studies. Treatment consists of bougienage, forceful dilation, and Heller esophagocardiomyotomy.