Seventeen patients with achalasia were treated by endoscopic myotomy limited to the esophageal rosette and avoiding the distal antireflux zone. Clinical, radiological, endoscopic, and manometric follow-up revealed improvement comparable to that seen in patients after successful surgical myotomy or pneumatic dilation. In the hands of the authors, the procedure has been simple, fast, effective, and safe, thus providing an alternative treatment of achalasia.