Most esophagogastric anastomotic strictures can be successfully managed with endoscopic dilation. However, strictures that do not respond to repeated dilation (refractory strictures) are difficult to manage. We report a series of nine patients treated with needle-knife electroincision of symptomatic esophagogastric anastomotic strictures refractory to balloon or Savary dilation. Prior to needle-knife electroincision, the median symptom-free interval between dilations was 13 days; median number of dilations was six (range 3-12). After electroincision, 8/9 patients have experienced a reduction in dysphagia symptoms and a reduced need for endoscopic dilations (follow-up: 90-420 days). No complications occurred. Needle-knife stricturoplasty of refractory esophagogastric anastomotic strictures may produce improved clinical results and may delay or eliminate dysphagia recurrence.