Gastrointestinal reflux disease in otherwise healthy adolescents is relatively uncommon. The frequency increases with other chronic medical conditions, such as cerebral palsy, asthma, and cystic fibrosis-and GERD should be included in the differential diagnosis of a wide range of airway and GI complaints. In this article, the authors review the clinical manifestations, pathophysiology, diagnosis, and treatment of GERD as it relates to the adolescent.