Aim of this study was to analyze the relationships between esophageal motility and pharmacology. The use of a drug during manometry may have three goals: physiopathologic, diagnostic and therapeutic. In the first case, the manometric examination after administration of drugs, hormones and neurotransmitters allows to study esophageal receptors and innervation and to understand the alterations that are at the basis of esophageal motility disorders. Pharmacological stimulations with Bethanechol and Edrophonium is useful in the diagnosis of non cardiac chest pain, when alterations of esophageal motility are sporadic and difficult to diagnose with a standard manometric examination. Finally esophageal manometry is indispensable in clinical practice to establish therapeutic activity and mechanism of action of drugs.