On the basis of a study performed in 141 cases of hiatal hernia that have been hospitalized in the clinic a series of clinico-therapeutical considerations are made, with surgical implications. The most frequently encountered type of hiatal hernia was that occurring through sliding. Very frequently there are morbid associations (in over 60% of the cases) and this indicates the necessity for a complex study of the patients and a careful selection of the predominant affection. Only 81 of the patients that have been examined - that is 57% - had surgical indications. Two types of interventions have been associated: the correction of the diaphragmatic hiatus was always associated with an intervention in view of avoiding the repetition of the gastroesophagian reflux. Good and very good post-operative results have been obtained in 78% of the interventions and mediocre results in 22% of the operated patients.