Abstract Background: Laparoscopic Heller myotomy with a partial fundoplication is the mainstay of surgical treatment of achalasia of the cardia. The failure of surgical therapy in the treatment of achalasia is related to different causes that have not yet been conclusively defined in the literature. Aim of Study: To analyze different predictors of recurrence of achalasia after surgical treatment. Patients and Methods: This is a retrospective study that was conducted to patients who underwent surgical interventions for achalasia at Gastrointestinal Surgical center (GISC), Mansoura University, Egypt during the period between January 2007 and December 2017. The aim of this study is to analyze different predictors of recurrence of achalasia after surgical treatment. Results: 191 patients underwent Heller cardiomyotomy with a mean age of 37.08±14.98 years and mean body mass index of 24.78±6.98kg/m2. Recurrence of achalasia occurred in 33 (17.3%) patients. Surgical remyotomy was performed in 14 (42.42%) patients while balloon dilatation was performed in 19 (57.6%) patients. Factors associated with higher recur-rence rate were higher Eckhardt Score and younger age (p < 0.05). Conclusion: Age was negatively correlated with recur-rence. However, Eckhardt score was positively correlated with it. Moreover, binary logistic regression revealed that younger age is a strong predictor of recurrence after surgical management of achalasia.