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Per Oral Endoscopic Myotomy (POEM)– Achalasia cardia is disease of esophagus characterised by difficulty in swallowing of food and liquids. The underlying cause is failure of relaxation of lower esophageal sphincter (LES). LES is tight muscle between esophagus and stomach, function of LES is to prevent reflux of acid of stomach in esophagus. In patients with achalasia cardia, this sphincter does not relax leading to difficulty in swallowing and drinking. POEM is novel completely endoscopic treatment, where tight muscle is cut very carefully. POEM is efficacious and safe treatment without any need of skin incision.