Gastroesophageal reflux disease (GERD) is the excessive reflux of gastric and duodenal contents into the esophagus, causing symptoms such as heartburn, acid reflux, dysphagia, and even pathological damage to the esophageal mucosa——reflux esophagitis , RE). In western countries, the incidence of GERD accounts for about 30-40% of the overall population, and the incidence of RE accounts for about 20% of patients undergoing endoscopy; epidemiological surveys in Beijing and Shanghai show that the incidence of GERD is as high as 5.77% and the incidence of RE is 1.92%. The disease has become one of the most common diseases that endanger people’s health and is closely related to the occurrence of esophageal cancer. Among the many factors in the development of GERD, lower esophageal sphincter dysfunction resulting in lower resting pressure has been considered the most important factor in the development of GERD. However, some patients with milder forms of GERD tend to have normal resting pressure, and their transient relaxation of the lower esophageal sphincter during non-swallowing is the main pathogenic mechanism causing GERD. Gastric acid has long been considered the main factor causing esophageal injury in GERD patients, but the reflux of duodenal fluid into the esophagus also plays an important role. Acid and bile are jointly involved in esophageal mucosal injury, and the more severe the esophageal injury, the higher the percentage of mixed reflux occurs. Esophageal 24h pH monitoring, esophageal manometry, PPI test can clarify the diagnosis of GERD, endoscopy can determine the extent of esophageal lesions, and barium X-ray meal fluoroscopy can detect coexisting esophageal hiatal hernia. GERD treatment should be comprehensive, and changing the diet and lifestyle is the first step of treatment. Depending on the severity of the disease, pharmacological treatment can include antacids, H2-blockers, and proton pump inhibitors. Approximately 25% of patients whose disease worsens during medical treatment require surgical treatment, the goal of which is to improve the patient’s quality of life rather than to save his or her life. Patients aged 45 years with symptoms such as weight loss, dysphagia, upper gastrointestinal bleeding, Barrett’s esophagus on endoscopy, and those who have not recovered from regular medical treatment should undergo surgery. Traditional dissection for anti-reflux surgery has a history of success for more than 40 years, but the surgery is more invasive and has a higher incidence of complications such as intraoperative splenic injury. Since 1991, when Dallemagne et al. first reported the application of laparoscopic fundoplication for GERD, laparoscopic anti-reflux surgery has been rapidly promoted, and its efficacy is the same or even better than that of caesarean surgery, with less trauma, faster recovery, fewer complications, and lower mortality being its obvious advantages over caesarean surgery.