Abstract: Objective: To investigate esophageal motility and esophageal acid exposure in elderly and non-elderly patients with gastroesophageal reflux disease（GERD）. Methods: Esophageal manometry and 24-hour pH monitoring were performed in elderly control group（n=16）,non-elderly control group（n=18）,elderly patients（n=46） and non-elderly patients（n=23）. Results: Elderly and non-elderly patients with esophagitis showed a lower LESP as compared to corresponding controls.Elderly and non-elderly patients,especially with esophagitis,showed a lower pressure of contraction at the distal esophagus as compared to corresponding controls,and the pressure was lower significantly in elderly patients than in non-elderly patients.The subgroup of elderly patients with esophagitis had a higher number of reflux episodes lasting for more than 5 min than the subgroup of elderly patients without esophagitis.And the subgroup of non-elderly patients with esophagitis had a higher total percent of reflux time than the subgroup of non-elderly patients without esophagitis. Conclusions: The functions of esophagus antireflux and the peristaltic activity of the esophagus impaired in elderly and non-elderly GERD patients with esophagitis,and the esophagus peristalsis in elderly patients more severely impaired as compaired to non-elderly patients.The injury of esophagus in elderly GERD patients was associated with the delayed acid clearance,and the injury of esophagus in non-elderly GERD patients was associated with the increased acid exprosure.