Long-term follow-up of patients with achalasia has revealed recurrences many years following an initially successful cardiomyotomy. In three patients with recurrent achalasia, one previously operated on by us and another twice recurrent, we were confronted with an apparently previously complete myotomy at reoperation. We elected to perform a cardioplasty using the Y-V principle employed previously in duodenal stenosis. We added a Belsey type of partial plication. Five-year follow-up with history, esophagram, esophageal function studies, and endoscopy has revealed no recurrence of dysphagia and no symptoms of reflux or esophagitis.