Gastroesophageal reflux disease (GERD) is a common disorder affecting approximately more than 10% of the population. GERD is highly heterogeneous in terms of varied manifestations, test findings and treatment responsiveness. The invasive treatment options for GERD have now greatly expanded from just the Nissen Fundoplication to various other options such as other minimally invasive options like the Lower Esophageal augmentation with a magnetic device, and multiple endoscopic options like Radiofrequency ablation, Trans-oral incisionless fundoplication (TIF) etc. Treatment options require an understanding of the patho-physiology of GERD, which is discussed in chapter one of this book. Chapter two studies the clinical practices for extra-esophageal reflux and explores the outcomes. Chapter three reviews extraesophageal reflux and sleep microarchitecture disturbance and excessive daytime sleepiness. Chapter four discusses osteopathic manipulative therapy. The final chapter provides updated research on the surgical treatment options for GERD and their long-term outcomes.