Gastroesophageal reflux disease (GERD) is one of the most common disorders of the gastrointestinal tract. Laparoscopic anti-reflux surgery has been shown to be safe and effective for the treatment of GERD with excellent symptom control. However, an approach to the treatment of GERD that has less morbidity than surgery and obviates the need for drugs is desirable. The endoscopic delivery of temperaturecontrolled radiofrequency energy (RF) to the gastroesophageal junction (GE), termed Stretta (Curon Medical, Sunnyvale, CA, USA), has recently been shown to be safe, well tolerated, and highly effective in patients with GERD. We review the basic principles, technique, potential mechanisms of action, and effectiveness of the Stretta procedure.