Aim. The aim of the present study was to prospectively evaluate the Stretta radiofrequency (RF) treatment for gastroesophageal reflux disease (GERD) -related respiratory symptoms over a 5-years follow-up period. Methods. A total of 132 patients underwent the Stretta procedure between April 2007 and February 2009; 122 of the patients (92.4%) completed the 5-year follow-up. Symptom scores and PPI usage were evaluated at baseline, 6 months, 1 year, 3 years and 5 years after treatment. Results. A total of 122 patients (age, 51.7 +/- 13.0 years, M:F, 52: 70) were followed up for 5 years and their outcomes were analyzed. At 5 years after treatment, the symptom scores were significantly reduced (heartburn score, from 5.67 +/- 1.52 to 2.41 +/- 1.13; regurgitation score, from 5.43 +/- 1.66 to 2.27 +/- 1.33; chest pain score, from 4.45 +/- 1.47 to 2.40 +/- 0.88; cough score, from 6.62 +/- 1.73 to 3.14 +/- 1.43; and asthma score, from 6.83 +/- 1.46 to 3.26 +/- 1.53, P<0.001). Moreover, 56.6% of the patients were completely off PPIs. Conclusion. Stretta RF significantly improves the symptoms and reduces PPI usage at 5 years. Therefore, it is a viable, effective, and minimally invasive endoluminal procedure for patients with GERD-related respiratory symptoms.