Gastroesophageal reflux disease (GERD) is a chronic condition characterized by the backflow of stomach contents into the esophagus, affecting millions of people worldwide. Its pathophysiology involves a combination of factors, including the weakening of the lower esophageal sphincter (LES), increased intra-abdominal pressure, delayed gastric emptying, and hiatal hernia. Although lifestyle modifications and pharmacological treatments are usually sufficient to control symptoms, some patients may require surgical intervention when these approaches are inadequate. The goals of surgical treatment for GERD include anatomical correction, elimination of reflux symptoms, and prevention of complications. Surgical indications include symptoms resistant to medical therapy, dependence on and side effects of medications, reflux-related complications, and hiatal hernia. This chapter provides a detailed examination of the indications for surgical treatment of GERD, the surgical techniques used, and the advantages, disadvantages, and potential complications of these techniques.