BACKGROUND: The stomach and esophagus may be the origins of chest pain clinically indistinguishable from that of myocardial ischemia. When the coronary angiogram is normal or minimal lesion, motility studies are important for adequate diagnosis. OBJECTIVES: This study investigated the identification of gastro-esophageal disease in patients with chest pain and showing negative coronary angiogram. METHODS: 126 patients (male 42, 33.3%) who showed negative coronary angiogram with typical chest pain were included. All patients underwent esophagogastroduodenoscopy, and most of them were performed Berstein test and esophageal manometry. RESULTS: Among the 126 patients, clinically stable angina was in 109 (86.5%). Stress test was done in 84 (66.7%; positive 53, 63.1%). Endoscopical finding was normal or nonspecific gastritis in 78 patients (62.5%), erosive gastritis in 18 (14.3%), gastric ulcer in 5 (4.0%), duodenal ulcer in 7 (5.6%), reflux esophagitis in17 (13.5%). One case of stomach cancer was detected during endoscopy. Berstein test was done in 122 patients. Positive result was 68 patients (55.7%). 59 (48.4%) of them was non-erosive reflux disease. Esophageal manometry was done 121 patients. 35 patients (28.9%) of them had motility disorders. Nutcracker esophagus was in 24 patients (19.8), nonspecific esophageal motility disorder in 5 (4.1%), hypertensive lower esophageal sphincter in 3 (2.5%). Among the 53 patients of positive cardiac stress test with negative coronary angiogram (clinically corresponded to microvascular angina), 46 patients (86.8%) showed abnormal findings in gastro-esophageal studies. CONCLUSIONS: In this study, 107 (84.9%) of patients with chest pain and showing negative coronary angiogram revealed positive result of gastric or esophageal disease. In spite of existing microvascular anginal evidence, it will be more advisable to perform gastro-esophageal studies.