Cardiac achalasia is one of the rarest illnesses of the esophagus. adults are more prone to cardiac achalasia. Occasionally it may occur in adolescence and late childhood but it is very rare in infancy. Cardiac achalasia is a primary motility disorder of the esophagus which is characterized by the absence of effective peristalsis in response to swallowing and a failure of relaxation of the lower esophageal sphincter (LES). The diagnosis of early-onset cardiac achalasia depends mainly on symptoms which the patient complains. The main symptom is retrosternal discomfort or dysphagia. These symptoms can’t be informed by a nonverbal infant. Failure to thrive or gradual loss of weight and recurrent respiratory tract infection with cough during sleep are nonspecific manifestations for diagnosis of cardiac achalasia in infancy. No specific signs present during Physical examination. Barium swallow remains one of the most important tools for the diagnosis of achalasia. We report a case of achalasia in infants. We have described an 11-month-old boy with cardiac achalasia who presented with recurrent vomiting, failure to thrive, and recurrent chest infection. Our case was treated with Heller’s esophagocardiomyotomy and anti-reflux procedure.