Recent advances in technology have made it possible to detect gastroesophageal reflux (GER) through monitoring of esophageal pH, lower esophageal sphincter pressure, and esophageal motility for prolonged periods, including sleep. When these methods are applied to patients with chronic respiratory disease, as many as 65% have GER; improvement in respiratory status has often been reported after treatment of the GER. This article reviews the evidence for the association between GER and chronic respiratory disease, the possible physiologic mechanisms underlying this association, and the implications for therapy.