This issue of Thoracic Surgery Clinics of North America, guest edited by Dr. Brian E. Louie, is devoted to Innovations in the Management of Foregut Disease. Dr. Louie has assembled expert authors to review the following topics: Endoscopic approaches to cricopharyngeal myotomy and pyloromyotomy; Options for the challenging hiatus during paraesophageal hernia repair; Endoluminal therapies for esophageal perforations and leaks; Extraluminal approaches to GERD; Advanced endoluminal technologies for Barrett's esophagus - focus on OCT and CLE; Mucosal ablation techniques for Barrett's esophagus and early esophageal cancer; Best practices for training, education and introduction of new techniques for foregut disease management into clinical practice; Per Oral Endoscopic Myotomy (POEM) for Achalasia; Endoscopic resection of tumors of the esophagus; The role of the functional probe in esophageal disease; Enhance the detection of Barrett's esophagus; Endoluminal approaches to GERD; The role of functional fluorescence imaging during esophagectomy; and more!