Primary esophageal motility disorders are those named alterations in esophageal motility not attributed to an identifiable cause, such as gastroesophageal reflux disease or opioid usage. Apart from achalasia, other primary esophageal motility disorders are: esophagogastric junction outflow obstruction, absent contractility, distal esophageal spasm, hypercontractile esophagus, and ineffective esophageal motility. Diagnosis follows specific manometric patterns and the concomitance of clinically relevant symptoms and in some cases adjunct tests. Treatment is usually aimed towards actions modulating esophageal contractions for the spastic disorders or lifestyle changes for hypomotilities, after the exclusion that the disease is not secondary to other causes.