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Functional disorders of the esophagus are known as esophageal dysmotility disorders. Esophageal manometry can be used to study swallowing disorders, feeding problems, nonobstructive dysphagia, and lower esophageal dysfunction. This paper discusses the recent advances in and reviews the use of high-resolution esophageal manometry in children. The Chicago 4.0 classification should be used judiciously in children. Manometric studies can guide the proper management of dysmotility in children.