Objective To observe the effects and benefits of the gastroscopy-assisted thoracoscopic modified Heller operation for the treatment of achalasia of cardia. Methods Retrospective analysis was conducted on the clin﹣ical data of 33 cases in our hospital. The surgical approach was gastroscopy-assisted thoracoscopic modified Heller operation. The intraoperative and postoperative effect and complications were observed. All patients were followed up for six months. Results After operation 33 achalasia patients' symptom of obstruction is alleviated. 1 case changed to open operation because of severe adhesion; 4 cases esophageal mucosal were injured and need to be repair assisted by thoracoscope. 1 case had esophagopleural fistula after operation and was cured by conservative treatment in one month. 1 case had gastroesophageal reflux symptoms after operation and relief symptoms after conservative treatment. All patients were follow-up more than six months, only 1 patient recured eating obstruction in 3 months after opera﹣tion, and was cured by gastroscopic expanding treatment. Conclusions The results of gastroscopy-assisted thoraco﹣scopic modified Heller operation to patients with Achalasia is significant. The operation is easy to perform and the complications is less, it can be promoted and applied in clinical practice.