The relative efficacy of double- and single-contrast radiographs of the esophagus in the detection of esophagitis was compared with findings at esophagoscopy in 52 patients. The addition of double-contrast views to the examination increased the number of radiographic abnormalities seen and led to the radiographic detection of esophagitis in four patients in whom the diagnosis would otherwise have been missed. The use of double-contrast views did not lead to significant improvement in the overall accuracy, however, since their use was associated with an increase in the false-positive interpretation rate. Superficial mucosal irregularity, ulcers, and narrowing were the most specific radiographic abnormalities and all were detected more frequently on double-contrast views.