The use of the Angelchik antireflux prosthesis has increased rapidly in our community since its introduction in 1979. Our experience with two patients who had serious complications associated with this prosthesis led us to review all 76 patients in our community who had undergone implantation of the device. Complications developed in 20 patients after placement of the prosthesis, and 12 of them required subsequent laparotomy for removal of the prosthesis. The complications observed were persistent dysphagia, late-onset dysphagia, transient dysphagia, persistent vomiting, esophageal obstruction, early gas bloat syndrome, gastric erosion, slippage of the prosthesis over the gastric fundus, disruption of the prosthesis, and migration of the prosthesis. Because of the frequency of potentially serious complications, we cannot recommend its use in the surgical treatment of esophageal reflux.