Hiatal hernia refers to conditions in which elements of the abdominal cavity, most com- monly the stomach, herniate through the esophageal hiatus into the mediastinum. Hiatal hernias (type I) are the most common type (85-95 %). Types II, III and IV are all varieties of paraesophageal hernias. In Makuuchi classification, sliding hiatal hernia is readily diag- nosed by endoscopy when greater than 3 cm in axial span. In western countries, it is diag- nosed when greater than 2cm. High-resolution manometry with pressure topography plotting allows for precise localization and quantification of the individual physiological elements of the esophagogastric junction. In recent study, anti-reflux mucosectomy(ARMS) could represent an effective anti-reflux procedure.