Achalasia cardia is an uncommon esophageal motility disorder with incomplete relaxation of the lower esophageal sphincter and esophageal dysmotility. The annual incidence is 0.5–2% in 100,000, and it is seen in males and females and all races equally. It is associated with difficulty in swallowing more with liquids than solid food along with regurgitation. High-resolution esophageal manometry and therapeutic approach of upper gastrointestinal endoscopy have brought new modalities of treatment of achalasia cardia. The optimal treatment for achalasia remains controversial and mainly depends on the type and preference of the physician. In the following chapter, we take you through the various modalities of treatment for achalasia cardia, the newer tools for diagnosing and following up the patients treated by various invasive procedures with special reference to role of minimally invasive approaches and laparoscopy in treatment of achalasia.