For operative treatment of achalasia transabdominal myotomy combined with a semifundoplication was performed in 37 patients. 35 patients could be followed up during an average period of 41 months. 19 patients (54%) were completely and 12 (34%) almost symptom-free. In one case a peptic esophageal stenosis developed. The results of operation were especially in the group of young patients under 40 years favourable and there was no influence on results of preoperative duration of symptoms or number of dilatations before surgery. Transabdominal myotomy with semifundoplication has shown as a procedure with low complication rates and good long-time results for the symptomatically therapy of achalasia.