Mountain cardia achalasia is a state of persistent spasm in the cardia area of the lower esophagus, causing symptoms such as feeding obstruction and regurgitation. A barium meal has a typical presentation and can confirm the diagnosis. Gastroscopy is used to exclude other lesions of the cardia. The effect of surgical treatment is more certain. The results are better. But there is trauma. Other treatments such as pancreatic balloon dilation and injectable drugs can relieve symptoms, but are prone to recurrence and inconvenience future surgery because of the potential for submucosal adhesions. Treatment with stenting (desirable) dilation is also available. Minimally invasive thoracoscopic surgery is possible, reducing trauma and facilitating recovery.