Purpose: Gastroesophageal Reflux (GER) has been commonly recognized in young and middle-aged patients with noncardiac chest pain (NCCP). GER prevalence rates are higher in older patients with typical presentation forms of the disease. There is paucity of information regarding the prevalence of GER in older patients with atypical forms of GER, i.e. NCCP. It is also unknown whether there are any differences in clinical presentations (heartburn/regurgitation) between young patients with NCCP and their elderly counterparts. HYPOTHESIS: GER is more prevalent in older than in younger patients with NCCP. AIM: Evaluate if there are differences in the prevalence rates of GER in our patient population with NCCP based on their age. Methods: Consecutive patients referred for evaluation of NCCP to a single investigator (SRA) during a 5-year period were included in this study. Patients were deemed to have NCCP by cardiology consultation and at least one objective cardiac imaging test. The results of demographics, GERrelated symptoms, esophageal motility, 24-hour ambulatory esophageal pH testing and upper endoscopy (EGD) were compared according to age: 65 years old versus 50 years old. Subjects ages 50–65 were excluded from the analysis to allow for a clear separation of the data. GER diagnosed by pH if acid contact time was abnormal and/or if a minimum of erosions were noted at EGD. Statistics by Chi square (p 0.05 was considered to be significant). Results: During the study period, 179 patients were referred for evaluation of NCCP. Mean age 57.1 years (range 24–90, SD 13.6), 122 (68%) were female. The age/gender (female F) distribution was as follows: 50 years 57/179 (32%), F 36 (68%); 65 years 64 (36%), F 41 (64%).