Gastroesophageal reflux disease (GERD) is a well-defined disease characterized by symptoms or complications caused by an abnormal amount of gastroesophageal reflux (GER), which is a retrograde movement of gastric contents into the esophagus. An estimated 25 to 75 million people in the United States are affected by GERD, and 13% of Americans use medications at least twice weekly. 1 Laryngopharyngeal reflux (LPR) is considered a subset of GERD and its own identity, because the main symptomatic region involves the laryngopharynx. Although the hallmark symptoms of GERD include heartburn and regurgitation, symptoms of LPR often include cough, throat discomfort, and hoarseness, which are also termed extraesophageal symptoms. In some patients with LPR, the extraesophageal symptoms occur in conjunction with classic symptoms, whereas in others the respiratory symptoms are the only manifestations of GER.Increased interest has been shown in LPR in the past 10 to 15 years. LPR has become one of the more frequently diagnosed conditions in otolaryngology. 2 It has been reported that up to 10% of otolaryngologic clinic patients overall and approximately 50% of patients with voice complaints have been diagnosed with LPR. 3 LPR has been linked to several disorders, including chronic laryngitis, chronic dysphonia, chronic cough, asthma, laryngotracheal stenosis, vocal cord lesions, and laryngospasm. Pathophysiology of LPR is likely multifactorial. Numerous studies have been undertaken to clarify the pathophysiology of LPR, and these have shown that both direct refluxate contact of the laryngopharynx and indirect reflexive laryngospasm likely account for symptoms of LPR. Accurate diagnosis of LPR has been elusive, but implementation of direct reflux monitoring using pH probe and impedance studies in addition to laryngoscopies have proven useful. This article describes other diagnostic modalities on the horizon that may offer improved diagnostic accuracy. The treatment of LPR has been similar to that of GERD. Lifestyle modifications and medical and surgical treatment have had mixed results.Although evaluation and treatment of LPR has been challenging, promising progress has been made in delineating the complex pathophysiology and realizing the wide array of clinical manifestations. In addition, advancements have been made in developing new diagnostic tools and understanding how to treat patients with LPR.