ABSTRACT Achalasia is a rare esophageal motor disorder characterized by incomplete relaxation of the lower esophageal sphincter and ineffective contraction of the esophageal body. This condition is not often associated with obesity; however, in recent years, cases of achalasia after bariatric surgery have been described. We describe the case of a 30-year-old female patient with a history of gastric sleeve surgery in 2018, which, 4 years after the intervention, presented with dysphagia, regurgitation, and weight loss. A diagnosis of achalasia was made, and peroral endoscopic myotomy was performed.