Achalasia is a rare esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) with absent or spastic contractions of the esophagus. Relaxation of the esophageal smooth muscle is impaired by a loss of inhibitory nerve function of the esophageal myenteric plexus. The evaluation of a patient suspected to have achalasia involves the barium esophagram and upper endoscopy to rule out structural causes of dysphagia, and a definitive diagnosis is made with high-resolution manometry. There is no curative therapy for achalasia; however, symptoms can be palliated with medical and surgical treatments. Medical management includes pharmacotherapy such as calcium channel blockers, beta-agonists, anticholinergics, phosphodiesterase inhibitors, and nitrates. Pharmacotherapy is the least effective treatment option for achalasia and carries a high incidence of adverse effects. LES botulinum toxin injection and pneumatic dilation can also be used as nonsurgical management, but have been found to be inferior to surgical options. Surgical management includes per-oral endoscopic myotomy and laparoscopic or robotic-assisted Heller myotomy. Endoscopic functional luminal imaging probe (EndoFLIP) is a balloon-based catheter that can be used intraoperatively to measure the effectiveness of therapeutic intervention. Intraoperative complications include esophageal or gastric perforation and vagal nerve injury. Postoperatively, patients are admitted to the surgical team and can commence a clear liquid diet immediately. Scheduled antiemetics such as ondansetron can prevent emesis and serve to protect the fundoplication. Discharge can occur within 24 h, with the patient transitioning from a clear liquid diet to a soft diet at home.