Gastroesophageal reflux disease is prone to recurring attacks. Acid-suppressing drugs are the first choice for treatment, but about 30% demonstrates poor effects, which are called the refractory GERD (rGERD). Surgery, especially laparoscopic fundoplication, is widely applied for GERD patients with hiatal hernia. The effect is clear, but the trauma and the cost are high. In recent years, minimally invasive endoscopic treatments have been applied to treat rGERD, such as intracavitary folding and suture, radiofrequency ablation, filling injection, and implantation. But there are still some problems, such as the requirement of costly proprietary devices or foreign objects left in the body. In 2003, Professor Inoue [1] and others from Japan underwent endoscopic peri-mucosal resection of esophagus on a refractory GERD patient with high-grade dysplasia arising from Barrett’s esophagus. They found the symptoms of GERD were improved after the operation, due to fibrosis at the gastric cardia. Based on this, Professor Inoue [2] used this method to treat ten patients with refractory GERD successfully in 2014, and for the first time proposed the concept of anti-reflux mucosal resection (ARMS). Relevant research carried out since then confirms that ARMS is a safe, effective, and promising endoscopic treatment technique for refractory GERD.