The palliation of patients with megaesophagus secondary to achalasia of the cardia presents significant challenges to the surgeon. Experience with palliation of megaesophagus secondary to Chagas' disease suggests that options other than cardiomyotomy or oesophagectomy can result in satisfactory outcomes. A small series of patients with non-chagasic megaesophagus who were treated with a gastroesophagoplasty procedure is discussed.