Laryngopharyngeal reflux (LPR) is an extraesophageal variant of gastroesophageal reflux disease (GERD) that affects the larynx and pharynx. In recent years, many otolaryngologists have acknowledged the existence and potential importance of LPR in patients with otolaryngologic complaints, (1) although the association between acid reflux and laryngeal abnormalities has been recognized for more than 4 decades. (2-7) As otolaryngologists have been more diligent about looking for signs of LPR--such as posterior laryngeal edema and erythema, obliteration of the laryngeal ventricles, and interarytenoid hypertrophy--treatment for LPR based on these findings has become increasingly common. Because of a paucity of convincing evidence regarding techniques for establishing definitive diagnosis and causation in individual patients, and because of a plethora of imperfect studies that have produced conflicting conclusions, LPR diagnosis and management remain controversial. Nevertheless, most recent evidence suggests that LPR represents a complex spectrum of abnormalities. It is essential for otolaryngologists and gastroenterologists (as well as other healthcare providers) to understand the latest concepts in basic science and clinical care of patients with LPR.