Forty-six patients with diffuse spasm of the esophagus, hypertensive gastroesophageal sphincter, or localized esophageal spasm occurring either singly or in combination, have undergone long esophagomyotomy at the Mayo Clinic as of July, 1963, without mortality or significant complication. Of the patients under study, 78% were symptomatically improved by the operation. Late postoperative esophageal motility studies on 23 patients operated on prior to 1962 showed that the reduction in pressure seen in the incised region soon after operation was maintained during the follow-up period in all but one patient. Manometric evidence suggestive of a hiatal hernia was present in eight patients, but was without roentgenographic confirmation.