The role of radiologic imaging in evaluating patients with suspected GERD has been clarified in recent years. The barium esophagram is used primarily for detecting the gross morphologic changes of reflux esophagitis and is a reliable screening method for diagnosing the more severe grades of disease. Evaluation of gastroesophageal reflux by barium examination is less certain; the technique is poor if only spontaneous reflux is detected but may improve with the use of provocative tests. The radiographic method is also useful for qualitative assessment of esophageal function and clearance. Radionuclide imaging is most useful for evaluating esophageal function and clearance but may not be as sensitive as initially reported for demonstrating gastroesophageal reflux.