We performed the esophagocardioplasty with gastric patch in the device of SATO and HIRASHIMA on 44 cases of achalasia of esophagus. We evaluated the post-operative results of these cases with esophago-cardiac manometry and pH measurement, which would be the best indicators on the esophago-cardiac function.We comfirmed that this method improved the passage prominently even in the progressed cases, judging the resting pressure and manometric configurations, and that this method preserved very well the anti-reflex function of the cardia, judging from the pH measurement.On the selection of the operative methods, we believe that, on the early cases, Heller's method and esophagocardioplasty with gastric patch are the choice and, on the progressed cases, esophagocardioplasty with gastric patch is to be performed.