The scope of therapeutic endoscopy, especially in the context of oesophageal dilatation, has greatly expanded in recent years. In this chapter we have described the currently used wire-guided systems and their dilatation technique. This technique can be used with most dilatation instrumentation now on the market. Perforation, the major risk of dilatation, is now rare (0.22% out of 909 dilatations with Savary-Gilliard bougies). Finally, we have presented the results of our own comparative studies for the Eder-Puestow, Savary Gilliard and Biomed systems and those of other authors for systems with which we have had no experience. In our opinion Savary-Gilliard bougies are the best, not only because of their greater flexibility and progressivity but also because of the improved safety tip of the guide wire.