Benign stricture dilatation and Achalasia Ballon Dilatation has been routinely performed by us over the past 15 yrs using Boston Scietific Maxforce Achalasia Cardia Balloon dilators , Savary guillard dilators and advanced keymed dilators since the begining. Though intitially we also used to perform dilatations under flouroscopy, now over the past few years we are routinely doing it under direct endoscopic vision, by inserting the endoscope after introducing the balloon over the guide wire or OTG bougie dilatation. We have had one patient who developed mild perforation following dilatation over the years which was managed conservatively. Given the fact that we have performed more than 750 dilatations to date our safety record in unblemished.