High resolution manometry (HRM) can provide useful functional information for evaluating patients experiencing recurrent symptoms after failed fundoplication surgery. The study evaluated 28 patients with various symptoms using HRM and compared results to healthy controls. HRM revealed high residual lower esophageal sphincter pressures, low rates of LES relaxation, and high intrabolus pressures in the neo-high pressure zone for most patients experiencing post-fundoplication dysphagia. HRM allows detailed analysis of complex esophageal pathology to provide insight for clinical decision making.