OBJECTIVE Radionuclide esophageal emptying test using a solid meal is a simple, noninvasive, and physiologic test of esophageal function. METHODS In this study, we evaluated esophageal emptying using an isotope-labeled solid meal (an egg salad sandwich labeled with 99mTc-MAA) in the assessment of pneumatic dilatation treatment in achalasia. Twenty achalasic patients (12 males, 8 females, age: 51.4 +/- 13.0 years) underwent esophageal emptying measurement before and after pneumatic dilatation. After treatment, the dysphagic symptoms of all patients improved. RESULTS In comparison with the pretreatment test, the posttreatment retention fraction at 1, 5, 10, and 15 min were significantly lower (P < 0.001). CONCLUSIONS The results suggest that radionuclide esophageal emptying test using a solid meal remains a useful objective study of esophageal function and may have an important future role in the follow-up evaluation of treatment for achalasia.