BACKGROUND: Esophageal manometry is a widely accepted technique for evaluation of esophageal symptoms. With esophageal manometry the clinician and researcher gather information on the function of neuromuscular processes in the esophagus and this allows identification of specific motor function abnormalities. METHODS: A review of the available literature on esophageal manometry with a special emphasis on high-resolution manometry. RESULTS: Indications for esophageal manometry are considered: endoscopy-negative dysphagia, noncardiac chest pain, to document the involvement of the esophagus in systemic disorders, to document esophageal motility prior to antireflux surgery and for placement of a pH probe. Conventional, stationary manometry can not be performed to confirm or rule out the presence of gastroesophageal reflux disease. Recently, high-resolution manometry was introduced. Current studies suggest that the yield of high-resolution manometry is higher than that of conventional pull-through manometry and is at least comparable to that of sleeve sensor manometry. Probably the most important advantage of high-resolution manometry is that it makes esophageal manometry much faster and easier to perform and to interpret. CONCLUSIONS: High-resolution manometry and topographic plotting of signals are a visually attractive way of presenting data; further studies will determine whether it is genuinely superior to conventional manometry.