INTRODUCTION: Achalasia has been described in the setting of obesity. Recurrent symptoms after Heller myotomyare not uncommon. Redo surgery for such cases is challenging especially in patients with history of gastric bypass. METHODS: This is a case of a 32 year old female with a history of achalasia status post laparoscopic Heller Esophagomyotomy then RYGB for morbid obesity. The patient presented with persistent dysphagia, diagnosed with recurrent achalasia and scheduled for Dor fundoplication takedown and redo esophagomyotomy. RESULTS: Upon accessing the abdominal cavity, dense adhesions between the left lobe of the liver and the anterior wall of the gastric pouch were encountered and taken down. The pouch was then meticulously dissected from the adhesions to the left crus of the diaphragm. The Dor fundoplication was taken down and a myotomy was done and extended into the lower mediastinum. A completion intraoperative EGD was performed to verify patency of the GE junction and the integrity of gastroesophageal mucosa. The procedure was concluded by closure of the diaphragmatic hiatus using unidirectional barbed sutures. The patient tolerated the procedure well and postoperative UGI showed no leak or obstruction. CONCLUSION: Redo esophagomyotomy in patients with history of gastric bypass is an acceptable yet challenging procedure for patients with recurrent achalasia after Heller esophagomyotomy.