Reflux disease continues to be one of the most common pathologies in the world. There is much discussion regarding the mechanism of developing and the variety of possible symptoms. Anti-reflux surgery is challenging and has become even more challenging with the introduction of alternative endoscopic and laparoscopic options for patients with gastroesophageal reflux disease (GERD). The Nissen fundoplication remains the gold standard for the durable relief of GERD symptoms and esophagitis. All anti-reflux procedures have a failure rate, and it is important to minimize factors associated with failure. The selection of patients for anti-reflux surgery and the choice of the procedure requires a thorough understanding of esophageal physiology and the pros and cons of various options. The purpose of this special issue is to discuss the clinical evidence and application status of the existing minimally invasive anti-reflux techniques and provide references for the development of this technology.