The incidence and clinical features of achalasia in Zimbabwe have not previously been documented. During a 10-year period (1974-1983) 25 cases were seen in Bulawayo and Harare. The estimated incidence is 0,03/100 000 members of the population per year, which is much less than the incidence in Europe and America. Achalasia occurred at any age and there was a preponderance of cases in males. Dysphagia was invariable and its duration varied from 2 weeks to 15 years. Parotid enlargement was found in 2 patients and respiratory infections occurred relatively frequently. The importance of excluding oesophageal carcinoma is emphasized.