Cardia achalasia is a disease caused by esophageal-neuromuscular dysfunction, which is mainly characterized by high pressure in the lower esophageal sphincter (LES) and a reduced relaxation response to swallowing movements, clinically manifested by dysphagia, chest pain, food reflux and vomiting after eating, and long-term attacks can lead to extreme wasting and malnutrition in patients. Current treatment mainly involves surgical severance of the lower esophageal muscle bundle to reduce the pressure of the LES to improve symptoms, but is highly invasive and poorly accepted by patients. Endoscopic balloon dilation or stent placement, endoscopic botulinum toxin injection and drug therapy are less invasive but have unsatisfactory long-term outcomes and high recurrence rates. With the continuous improvement of endoscopic technology, peroral endoscopic myotomy (POEM) has gradually become a new option for the treatment of pancreatic atelectasis, which was first applied clinically by Japanese scholar Inoue in 2009 and was first carried out in Shanghai Zhongshan Hospital in China at the end of 2010. It can be expected that POEM will replace traditional dilation and stenting as the preferred method for the treatment of cardia. POEM is a difficult and high-risk operation because it is performed under direct endoscopic view to completely cut off the circular muscle layer of the lower esophagus, and is currently performed in only a few large hospitals in China. On 2012-7-30, the first POEM was successfully carried out in our gastroenterology department, and now we have successfully completed 3 cases. The first patient, male, 38 years old, was admitted to the hospital with “feeling of obstruction in eating for 1.5 years”, and was diagnosed as “cardia achalasia” by barium meal and gastroscopy. The operation was performed by Dr. Wang Fangyu, the chief surgeon of our department, under tracheal intubation anesthesia, and took 1 hour and 35 minutes. Two days after the operation, the patient resumed a liquid diet, and the symptoms of dysphagia and vomiting after eating disappeared completely. The patient was discharged from the hospital 3 days after the operation. All is normal now at the follow-up. The POEM procedure was performed to bring new hope for the treatment of cardia incontinentia.