Gastro-esophageal reflux (GER) is a common occurrence in newborns and a cause of anxiety to most parents. This physiological process needs to be closely differentiated from pathological reflux. The clinical signs in infants are generally non-specific which makes the distinction difficult. The diagnostic options in infants are limited, have low sensitivity and not readily available. Treatment of GER is challenging both for the clinician and family. The mainstay of therapy involves use of conservative modalities with limited use of pharmacological agents and surgical methods. This review aims to amalgamate evidence based guidelines to our current clinical practice.