Promising endoscopic therapies for gastroesophageal reflux disease (GERD), including suturing and stapling techniques and injections of inert implantable materials, are emerging in both clinical practice and clinical investigations. Suturing and stapling techniques have undergone rapid development in the past few years. However, there are some potential advantages to the use of implantation procedures. These procedures are likely to be the least expensive to perform and also appear to be the least technically demanding. The various procedures and equipment have yet to undergo head-to-head clinical evaluation. The utility of endoscopic therapies for GERD will become more apparent when adequate data are available from well-controlled clinical trials and procedural databases. Further refinement, development, and differentiation of various endoscopic techniques are anticipated.