Antireflux surgery is an effective treatment for severe reflux disease with excellent control of symptoms. The limitations in the effectiveness of medical treatment of reflux necessitate the use of surgical intervention in a significant proportion of chronic gastroesophageal reflux disease (GERD) sufferers. Surgical techniques can physically correct the functional incompetence of the lower esophageal sphincter (LES), an unattainable outcome by medical intervention alone. Fundoplication, whether conducted by laparoscopic or open technique, is still a surgical procedure and carries some, albeit small risks. The laparoscopic technique has been used for the past 25 years. While early results demonstrate effectiveness, longer-term outcomes are under-reported and more variable. However, long-term relief of heartburn and regurgitation is seen in >85 % of patients. Side effects of gas bloating, abdominal distension, and flatulence are common following fundoplication. Early dysphagia is also common. However, persistent dysphagia is rare and often related to the type of fundoplication, with total fundoplication associated with higher incidence rates. Surgeon experience is also thought to play a role in the prevalence of the complication. Predictors for successful outcomes must be considered, including a lower body mass index (BMI), younger age, typical reflux symptoms, and absence of significant psychological factors. Generally, the long-term outcomes of antireflux surgery are good, particularly with appropriate patient selection. Results of re-operative procedures of fundoplication do not have equivalent rates of success as the primary but are still adequate.