Endoscopic therapies in proton pump inhibitor (PPI) dependent/refractory gastroesophageal reflux disease (GERD) are increasingly indicated in patients who are not suitable for or willing to undergo chronic medical therapy and surgical fundoplication. Currently available effective endoluminal antireflux procedures include transoral incisionless fundoplication (TIF), mucosal ablation/resection (ARMA/ARMS) techniques at the gastroesophageal junction, and the delivery of radiofrequency (STRETTA®). TIF by EsophyX™ 2.0 has strong evidence of efficacy in patients with small hiatus hernia, high-volume reflux episodes and troublesome regurgitation despite PPI therapy. ARMA/ARMS have shown promising results but need long term follow-up studies to prove their efficacy and cannot reduce hiatal hernia. STRETTA® might have a role in patients with reflux hypersensitivity and functional heartburn. Meticulous patient selection results in a favourable outcome with these endoscopic therapies, especially considering quality of life and PPI independence. Concomitant laparoscopic hernia repair and TIF by EsophyX™ 2.0/Z (cTIF) in patients with hiatal hernia greater than 2 cm is now emerging as a potential strategy within laparoscopic antireflux surgery. Future potential applications that are currently being investigated include the use of TIF in patients with achalasia after peroral endoscopic myotomy, obesity before and after sleeve gastrectomy/gastroplasty and Barrett’s esophagus.