Objective To investigate the significance of changes of esophageal peristalsis in hiatal hernia patients. Methods 32 patients with symptom of gastroesophageal reflux(esophageal hernia 10, hiatal hernia with esophagitis 12 and esophagitis 10) and 9 patients without symptom of reflux were selected.Lower esophageal sphincter (LES) pressure ,esophageal peristaltic velocity ,amplitude and duration were detected respectively;the degree of esophagitis was identified with gastroscopy. Results LES pressures in hiatal hernia with esophagitis group and simple esophagitis group were significantly lower than those in control group , there was no significant difference between hiatal hernia group and control group . In hiatal hernia group ,the peristaltic amplitudes of proximal and distal esophagus (51.3?5.4 mmHg and 83.6?8.3 mmHg) were significantly higher than those in the other three groups , while esophagitis group was significantly the lowest . There were no significant difference about esophageal peristltic duration both of proxmial and distal esophagus between these four groups .Furthermore , distal esophageal peristaltic velocity was significantly higher in hiatal hernia group than that in the other three groups , and it was the lowest in esophagitis group .Conclusion The changes of esophageal peristalsis in patient with hiatal hernia play an important role in the pathogenesis of gastroesophageal reflux and mucosal injury.[