Introduction. The study of achalasia of the cardia remains an urgent issue, since at present it is still impossible to say unequivocally about the etiology of this disease. Achalasia of the cardia is a rare disease, which is based on a primary disorder of the motility of the esophagus. It is characterized by a decrease in esophageal peristalsis and incomplete relaxation of the often tonally reduced lower esophageal sphincter in response to the act of swallowing [1]. Currently, three main hypotheses are being considered: genetic, autoimmune and infectious. Aims: to consider the features of the course of the disease of achalasia of the cardia on the basis of a clinical case of a 29-year-old patient. Description of the case. Examination of patient B, 29 years old, was performed on the basis of State Autonomous Healthcare Institution «Orenburg Regional Clinical Hospital №2» who was admitted in November 2022 with complaints of pronounced general weakness, shortness of breath during exercise, walking, difficulty breathing, weight loss by 50 kg since December 2021, inability to take solid food, and then liquid (even water), its outflow from the esophagus and mouth, without the urge to vomit and nausea, heartburn, chest pain. Patient since November 2021 noted these symptoms underwent inpatient treatment with a diagnosis of "Gastroesophageal reflux disease", "cardiospasm" in State Autonomous Healthcare Institution «Orenburg Regional Clinical Hospital №2». In November 2022, his condition worsened and he was hospitalized in the gastroenterology department. After laboratory and instrumental studies and consultations with specialist doctors, the patient was diagnosed with "Achalasia of the cardia of the II degree", a planned operation was shown endoscopic mechanical cardiodilatation with a Stark apparatus. After surgery, the patient's condition improved, food passes freely through the esophagus without delay. Discussion. Esophageal achalasia has recently become increasingly common in clinical practice among patients under 65 years of age, most often among men aged 20 to 50 years, among children under 16 years of age. The management of such patients requires a clinician to take a rational approach both in diagnosis and therapy, including in collaboration with other specialists (cardiologists, neuropathologists, psychiatrists). Conclusion. On the example of the presented case, the difficulties in diagnosis, a large complex of laboratory and instrumental methods of examination of this disease are obvious. The appointment of surgical treatment seems to be a reasonable method of treatment, and the course of therapy should be long. However, it is necessary to emphasize the fact that early diagnosis and the establishment of predisposing factors for the development of achalasia remains an important point.