Abstract Background Gastroesophageal reflux disease (GORD) in patients receiving a lung transplant has been associated with worsened graft function and decreased survival. This analysis aimed to identify whether fundoplication following lung transplant can improve graft function and overall survival. Methods patients undergoing lung transplantation between January 1993 and January 2020 were included. Data on oesophageal pH, manometry testing, post-transplant lung function testing and overall survival were collected. Cox-regression testing was used to analyse associations between oesophageal manometry and pH testing, fundoplication and overall survival. Results Of 345 patients who underwent a lung transplant, 20 patients also received fundoplication. 84 patients received oesopageal pH and manometry testing. Abnormal manometry was recorded in 41 patients. Average Demeester score was 28.45 for patients not receiving fundoplication and 37.28 for those receiving fundoplication. Average pre-operative reflux time was 8.6% for those not receiving fundoplication and 10.3% for those receiving fundoplication. Of 20 fundoplications, 4 were carried out within 1 year of transplant and 12 within 2 years. 1 patient had a post-operative complication following fundoplication. 13 of 20 patients had a positive response to fundoplication, defined as a less than 10% decrease in FEV1 lung function at 2 years. Receiving fundoplication was associated with better overall survival (p = 0.024) as was total reflux time <7% (p = 0.21). Conclusions Fundoplication is a safe operation after lung transplant with good outcomes. Fundoplication was associated with better overall survival on cox-regression analysis.