A simple method for obtaining double contrast images of the lower esophagus with the patient in a prone position is described. This technique has a high success rate, allows repeated imaging and is easily incorporated into routine upper gastrointestinal studies. Diagnostic double contrast studies were obtained in 78% of 28 patients. Ten abnormalities, including a Mallory-Weiss tear, were demonstrated. Single contrast esophagrams, performed immediately afterwards, demonstrated only 6 abnormalities.