Abstract : Achalasia is a rare esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and absence of peristalsis, resulting in dysphagia and reduced quality of life. Laparoscopic Heller myotomy (LHM) is considered the standard surgical treatment, aiming to improve LES function and relieve symptoms. This systematic review evaluates the functional and clinical outcomes of LHM in achalasia patients, focusing on LES pressure, esophageal diameter, and dysphagia scores before and after surgery. A comprehensive literature search was performed in PubMed, Google Scholar, and UpToDate using keywords “Esophagus”, “Achalasia”, “Myotomy”, and “Laparoscopy”. Studies included adult patients who underwent LHM with at least 12 months of follow-up and reported quantitative LES pressure or dysphagia outcomes. Study quality was assessed using the AXIS tool. Five studies including 232 patients (age range 9–78 years; 120 males, 112 females) met inclusion criteria. Postoperative outcomes showed significant reduction in basal LES pressure (mean decrease ~20 mmHg) and improvement in dysphagia (87.9%–97% of patients). Esophageal diameter decreased significantly where measured. Patient satisfaction was high, with 94–98% reporting improvement and willingness to repeat the surgery if needed. No perioperative mortality was reported. Laparoscopic Heller myotomy is a safe and effective treatment for achalasia, significantly improving dysphagia, LES function, and patient quality of life. LES pressure before surgery may predict symptomatic improvement.