Objective To analyse the clinical features of patients with gastroesophageal reflux disease(GERD)who had scores＜12 using reflux diagnostic questionnaires(RDQ).Methods A comparative and retrospective study was carried out in 148 GERD patients.Among whom 22 patients had low RDQ score(＜12)and 126 patients had high RDQ score(≥12).The differences in heart burn,substantial chest pain,regurgitation,severity and frequency of food reflux between two groups were compared.Nevertheless,the atypical symptoms such as chest distress.abnormal sensation of regurgitation or food reflux was significantly lower in patients with RDQ＜12 than those with RDQ≥accounted for 60.28%of the total RDQ score,whereas the heart burn,regurgitation and food reflux atypical symptom of chest distress was found in 13 patients(59.09%),abnormal sensation of throat in 8 patients(36.36%).cough and asthma in 3 patients(13.63%),headache in 5 patients(22.72%),belching in 9 patients(40.90%),aypnia in 8 patients(36.36%),and anxiety in 6 patients(27.27%).Conclusion RDQ is insensitive to those who have chest pain with no obvious symptom of heart burn,regurgitation or food reflux as well as those with atypical symptom beyond the RDQ.