Abstract Considering the dual innervation of the lower esophagus and cardiac end of the stomach, cardiospasm or achalasia might be expected to be a frequent complication of vagotomy. A review of the recent literature dealing with vagotomy indicates that this complication is seldom seen or reported. A case of cardiospasm following vagotomy in which the symptoms persisted for thirty-six days is reported. This complication would seem to be the result of an imbalance of sympathetic-parasympathetic innervation and not the result of local edema or irritation secondary to the operative procedure. As with the majority of other postvagotomy complications, it is self-limited.