Reflux describes a fluid flowing in the opposite direction to normal flow, often through a valve or sphincter. Reflux is synonymous with a degree of valvular or sphincteric incompetence. Gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus; a reflux event need not result in vomiting and can be innocent. Gastroesophageal reflux can appear asymptomatic or silent yet still cause pathology; its most mild manifestation is considered physiological. The lower esophageal sphincter (LES) is a distinct high-pressure zone in the lower esophagus, and when it transiently relaxes with prograde esophageal peristalsis, it may permit some reflux. In ruminants, reflux is physiological. Vomiting due to GER should be differentiated from other causes by clinical, radiological , endoscopic and 24 h esophageal pH monitoring studies. Medical managemnt with posture, feeding advice, pharmacological agents often result in control of GER. Surgical management is required for patients with failed medical management, those with acute life threatening episodes, anatomical abnormalities or neurologically impaired children. Different fundoplication operations are in practice which can even be performed by minimally invasive techniques. Other causes of dysphagia in children could be achalasia cardia and congenital esophageal stenosis.