1. The successful use of esophagogastrostomy with consequent relief of symptoms is reported after conservative measures were ineffective in a case of long standing cardiospasm (achalasia) complicated by tortuous dilatation and diverticulum formation. 2. The degree of clinical improvement noted following operation was in contrast to the comparative lack of change in the appearance of the lesion as seen in post-operative roentgenograms. 3. Esophagogastrostomy appears to be the operation of choice when the surgical approach to the treatment of cardiospasm must be considered.