The value of a "bread-barium" swallow for diagnosis of disordered esophageal motility was examined in 53 patients, 20 of whom complained of dysphagia, 20 retrosternal chest pain, and 13 heartburn; a further 19 subjects served as controls. Esophageal manometry in the patients with dysphagia and chest pain revealed major abnormalities in 14 compared with the bread-barium swallow which showed changes consistent with esophageal spasm in 20. The standard barium swallow examination revealed major abnormalities in only five of these patients. The bread-barium examination is simple, complements the routine barium swallow, and is of value in patients with symptoms suggesting disturbed motility. It does not replace conventional studies for the diagnosis of esophageal motility disorders.