Background: Dysphagia is considered an alarm symptom that mandates the performance of esophagogastro-duodenoscopy (EGD) as an initial diagnostic modality to exclude structural or mucosal lesions in the esophagus or the stomach cardia. Examples of these include tumors, inflammation, esophageal rings, strictures, and other pathologies that can mimic achalasia, a condition traditionally named pseudochalasia. Classic endoscopic findings of achalasia present in about half of the cases include widening of the esophagus, residue in the esophageal lumen, and obstructed EGJ. An additional important diagnosis is eosinophilic esophagitis (EoE), an immune-mediated/allergic disorder involving the esophagus causing dysphagia and diagnosed by eosinophils predominant inflammation. The diagnosis of achalasia is supported by esophagram findings including dilation of the esophagus, a narrow EGJ with “ birdbeak ” appearance, aperistalsis, and poor emptying of barium. It may also be helpful in cases where esophageal manometry may be associated with equivocal findings