A standardized method of performing pneumatic dilatation for the treatment of achalasia is described. Twenty-five patients were treated in this manner and 80% had excellent results. There was minimal morbidity and no mortality. Pneumatic dilatation is recommended as the primary procedure for achalasia as it is a simple and safe procedure which avoids unnecessary surgery. Local topical anesthesia, rather than general, is utilized and hospitalization time is two days, rather than the 14 days required following surgery. The Heller operation can be performed when pneumatic dilatation is unsuccessful.