INTRODUCTION: Because comparative effectiveness trials of eosinophilic esophagitis (EoE) treatments are lacking, patient preferences are often incorporated to select the ideal therapy plan. However, treatment uptake and adherence are often complicated by minimized symptoms, financial cost, convenience, perceived risk and knowledge. We aimed to explore motivators for treating EoE and barriers to using common therapies. METHODS: We developed and administered a web-based survey on factors which affect EoE treatment choices. Adult patients and caregivers of pediatric patients were recruited via patient advocacy groups and at two tertiary care centers. Descriptive statistics of multiple response questions were performed. RESULTS: Of 513 respondents, 47.4% were adults and 52.6% caregivers of pediatric patients (Table 1). The most common motivator to treat EoE was a desire to prevent complications or worsening disease (88.2% adults, 94.2% peds) (Figure 1). However, only half of adults felt that EoE could be a serious disease (54.1%) and 44.4% had trust that medications or diet could control it. The greatest barriers to topical steroids were potential side effects (58.2% adults, 63.4% peds), financial cost (34.1% adults, 19.3% peds), and preference for a medication-free approach (24.8% adults, 25.9% peds) (Figure 2). Inconveniences of a restrictive diet (36.3% adults, 27.6% peds), multiple endoscopies (30.4% adults, 26.8% peds), poor quality of life and socialization (23.7% adults, 27.6% peds), and inadequate nutrition (28.4% peds) were common barriers to diet therapy. Participants reported avoiding dilation because of belief that it is a high risk procedure (30.7% adults, 36.6% peds), discomfort (30.4% adults, 27.6% peds), and financial cost (31.1% adults, 20.6% peds). Additionally, 24.4% adults felt that they would avoid dilation because of inconveniences around having a procedure. CONCLUSION: Although only half of patients trusted that therapy could control EoE, preventing complications and worsening disease were the most important factors in pursuing treatment. Common barriers were inconvenience and financial costs. Side effects of steroids, quality of life and nutrition management for diet therapy, and discomfort from dilation were treatment specific barriers. To improve management of EoE and patient engagement, providers need to recognize challenges of both the disease and treatments, elicit patient preferences, and tailor therapy plans to individual attitudes and values.