Surgery for gastroesophageal reflux in infants and children has been shown to be safe and effective, but long-term results of the surgery have not been investigated. Because studies in adults show objective evidence of recurrent reflux five years postoperatively, we recalled 25 children for long-term follow-up of surgery. The preoperative symptoms of vomiting, apnea, pneumonia, and hematemesis were permanently controlled in all patients. Failure to thrive was reversed in all patients except those with multiple malformations. Extended esophageal pH monitoring revealed only one patient with symptomatic recurrent reflux. As a group, the children had significantly less reflux as measured by extended pH monitoring than did controls. Thirty-six percent of patients had mild to moderate symptoms of gas bloat. Thirty-two percent were described as very slow to finish most meals. Twenty-eight percent were unable to burp or vomit. Twenty-five percent choked on some solids. These symptoms did not correlate with the type of operation performed. Long term outcome of antireflux surgery in children is better than in adults.