Esophageal hiatal hernia (hiatus hernia) is a condition in which an intra-abdominal organ (mainly the stomach) enters the thoracic cavity through a diaphragmatic esophageal hiatus. Esophageal hiatal hernia is the most common of diaphragmatic hernias, accounting for more than 90% of cases. Patients with esophageal hiatal hernia can be asymptomatic or mildly symptomatic, and the severity of their symptoms is independent of the size of the hernia sac and the severity of esophageal inflammation. Hiatus hernia and reflux esophagitis can coexist or exist separately. The clinical manifestations are diverse and mainly include: 1. burning or hidden pain or distension or tight pressure in the retrosternal or epigastric region, with a wide spread of pain, occurring 30-60 minutes after meals, induced by squatting and bending and lying down, as well as precordial pain or full chest pain, and a few may present with acute abdominal manifestations. The pain is mostly relieved by itself within one hour, but when the paraesophageal hernia is embedded, there is sudden and severe epigastric pain with vomiting and difficulty in swallowing.2. Reflux symptoms: belching, acid reflux, heartburn, erratic reflux, vomiting, etc.3. Obstruction symptoms: when part of the stomach herniates into the chest cavity or esophagitis narrows or spasms the esophagus, there is choking, dysphagia or food stagnation behind the sternum when eating, initially intermittent, but may become persistent after a long time. It is intermittent at first, but can become persistent after a long time. Currently, there is a high rate of misdiagnosis, low rate of confirmation and low rate of standardized diagnosis and treatment of this disease in the clinic. This patient had been misdiagnosed with other diseases for many years, with symptoms such as chest pain, chest tightness and belching, and the ECG showed infarction pattern, and the coronary angiography was done to exclude cardiovascular diseases. We performed a laparoscopic esophageal hiatal hernia repair with fundoplication, with only five 0.5 cm incisions in the abdomen, and the patient was out of bed and eating on the first day after surgery, and was discharged three days after surgery with all symptoms gone and a normal ECG.