Achalasia is a rare motor disorder of the esophagus and its etiology and pathogenesis remain unclear. Its clinical presentation typically includes various degrees of dysphagia, regurgitation, aspiration, chest pain and weight loss. The main therapy purpose for achalasia is to reduce lower esophageal sphincter pressure (LESP) so as to alleviate clinical symptoms. There are a variety of treatment methods for achalasia, such as pharmacotherapy, intrasphincteric botulinum toxin injection, endoscopic pneumatic dilatation and surgical intervention. At present, most scholars prefer laparoscopic or thorascopic surgery to achieve satisfactory long-term results including alleviated symptoms and prevention of acid reflux. However, great controversy still exists among scholars regarding the choice of conservative therapy or surgery, transthoracic or transabdominal surgery, optimal distal extent of myotomy, the need and choice of additional antireflux procedures. In this review, we focus on current therapy and progress of achalasia.