Introduction: Several findings suggest that there is an association between atypical symptoms such as coughing, laryngitis, and chest pain and the presence of gastro-esophageal reflux. However, the cause – effect relationship is still controversial. Methodology: Data from 348 patients with atypical symptoms (coughing, laryngitis, and chest pain) and suspicious GERD who underwent 24-hour esophageal impedance pH monitoring were collected retrospectively. Results: The prevalence of GERD in the studies performed was low with 58% of the cases being normal. Most patients were females. The primary symptom in the abnormal studies was laryngitis, followed by chest pain (49% and 38% respectively). 57% of these patientsexhibited non-acid reflux. Conclusion: The prevalence of gastro-esophageal reflux in patients with atypical manifestations is low. The most frequent finding in patients with abnormal results after impedance esophageal pH monitoring was non-acid reflux.