Since its inception, laparoscopic fundoplication has revolutionized the surgical approach to gastroesophageal reflux disease (GERD). Endoluminal therapies for GERD are less invasive than surgery, seek to duplicate its efficacy, and may eliminate reliance on proton pump inhibitors (PPI) and other antisecretory drugs. The Stretta procedure uses radiofrequency (RF) energy delivered to the tissues of the distal lower esophageal sphincter (LES) and gastric cardia, which decreases LES compliance, increases LES muscle mass, and limits the inappropriate transient LES relaxations responsible for GERD in many patients. The Stretta procedure has been shown to be effective in laboratory studies, randomized sham-controlled studies, and numerous open-label prospective clinical trials. For patients with appropriate indications, the Stretta procedure is an effective endoluminal therapy for treatment of symptomatic GERD.