Gastroesophageal reflux is an important cause of chronic pulmonary disease. Particularly, chronic bronchitis and asthma are two common conditions in which there may be a chicken-and-egg association between the pulmonary problems and the gastroesophageal reflux. This interesting relationship needs to be considered in any patient with chronic pulmonary disease in whom the condition is progressing in spite of adequate medical therapy, in whom the history strongly supports this concept, and in whom laboratory tests suggest a causal relationship. Recognition and treatment of gastroesophageal reflux, either medical or surgical, can lead to improvement in the pulmonary condition of a large number of patients.