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The literal definition of dysphagia is "disturbed eating". However, it is more accurately described in clinical practice as a sensation of food or liquid being stuck in the esophagus or chest. If this sensation is associated with pain, it is labeled odynophagia, and if it is associated with persistent obstruction and bolus retention, it is categorized as a food impaction. Through research and technological advances, we continue to expand our understanding of the etiologies and underlying pathophysiology relating to this complaint. However, for now, our clinical algorithms focus on endoscopy and manometry to break down dysphagia into three categories: obstructive dysphagia, esophageal motility disorders, and functional dysphagia. Here, we review some critical pitfalls in our current clinical diagnoses, new proposed underlying mechanisms of esophageal motor disorders, and developing technologies to aid in diagnosis and treatment., Competing Interests: Competing interests: JEP has stock options in Crospon, has served as a consultant to Medtronic and Sandhill Scientific, has received grant support from Medtronic, and has received speaking fees from Medtronic, Sandhill Scientific, Takeda, and AstraZeneca. JRT declares that he has no competing interests.Competing interests: Mario Costantini has collaborated with Joseph R. Triggs and John E. Pandolfino on one consortium paper in the last three yearsCompeting interests: John Clarke attended the 2018 Stanford symposium for ineffective esophageal motility with John Pandolfino. Competing interests: Rami Sweis has collaborated with Joseph R. Triggs and John E. Pandolfino on two consortium papers in the last three years.