Aim: To determine the effectivesness of the Stretta procedure in GERDpatients and to compare it to conventional medical treatment. Methods:One hundred GERD patients were randomly assigned into 2 groups: AFiftypatient underwent Stretta, B- Fifty patients underwent medicaltreatment (rabeprazole 20mg/day) for 6 months, then the medicaltreatment was stopped for 6 months if possible. All patients wereevaluated by GERD HRQL, endoscopy, Manometry and 24 pH metry atbaseline, 6 months and 12 months. Results: Stretta patients had improvedGERD HRQL, LES pressure, esophagitis grade and distal esophagealacid exposure in 78% of patients at 6 months and 68% of patients at 12months. Medical treatment was associated with less morbidity and bettersymptom control than Stretta, but relapse occurred in the majority ofpatients after cessation of medical treatment. Conclusions: Medicaltreatment was associated with less morbidity and better symptom control than Stretta, However medical treatment relapse occurred in the majority of patients within 6 months of stopping the medical treatment.