The article weighs the advantages and limitations of high resolution esophageal manometry (HRM) technology. It traces the transition from water-infused orifices to miniaturized solid-state transducers and from uni-directional to circumferential since 1990. It explains the platform upon which HRM has been founded. The other potential applications of HRM in the field of neurogastroenterology and motility include defining other possible symptom-related defects.