Eosinophilic esophagitis (EE) is a disorder typically found in school-age and adolescent children, and is more prevalent in male patients. Patients with EE typically present with symptoms of heartburn or difficulties swallowing. Blood and x-ray studies may be normal or display non-specific findings. The diagnosis of EE rests on a combination of clinical symptoms, and the results of endoscopic and histologic studies. The endoscopic appearance of esophageal mucosa in these patients is often pale and displays a poor vascular pattern. The mucosa can be thickened in appearance. Esophagitis in patients with acid/peptic disease is typically more pronounced at the bottom of the esophagus, in the region of the gastroesophageal junction. In contrast, the mucosal disease observed in patients with EE is often more pronouced in the proximal esophagus. Treatment may include topial steroids (delivered systemically or via metered-dose inhaler) and formal allergy evaluation to detect potential dietary triggers. Anti-allergic therapies, including monteleukostat, benedryl, antihistimines, and cromolyn sodium have also been proposed as treatments for EE. Treatment efficacy is determined by a combination of clinical report and serial endoscopic study. There is currently no biochemical marker that can be used to monitor disease course in these patients.