In 43 patients with achalasia (postoperative 18, post-dilatation 15, preoperative 10, and 10 normal people) esophageal manometry, esophageal emptying barium test and endoscopy were employed. The results showed that the esophageal emptying index EEI was 13.3 +/- 9.0 in the postoperative group, 4.7 +/- 7.6 in the post dilatation group, 50.0 +/- 17.4 in the normal group, 2.9 +/- 4.3 in the preoperative group. A linear relationship was seen between EEI and the lower esophageal barium retention area (So) (t = -5.00, P < 0.001). In patient with higher EEI and smaller So stronger esophageal emptying function was noted at swallowing. 80% of patients with less than 12 esophageal anti-reflux index (ARI) suffered from gastroesophageal reflux EEI and ARI can evaluate not only the esophageal motor functions but also the therapeutic effects of different treatment methods. The therapeutic effects are determined by esophageal peristalsis pressure and LES relaxation rate after LES is relaxed.