Endoscope-based products for the treatment of more severe forms of gastroesophageal reflux disease provide an alternative to the use of drugs or surgery. Results from case series have shown that selected patients benefit through relief of symptoms and reduction of medication. Reported adverse effects appear to be minor. Efficacy has been mostly assessed over short periods and there is little information on comparison with other treatments. Procedural skills and appropriate training in their use are required. These technologies are promising, but their place in health care is not established.