To study the comparative efficacy of Thal’s fundoplication and Nissen’s fundoplication done to prevent gastroesophageal reflux (GER) after esophagocardiomyotomy for achalasia of the esophagus in children. Materials and Methods: This study was done over a period of seven years at the Niloufer Institute of Women and Children, Red Hills, Hyderabad. 12 cases of achalasia cardia were admitted to our institution. All cases underwent laparotomies and modified Heller’s esophago-cardiomyotomies. Results: There were 7 males and 5 females, with a male-female ratio of 1.4:1. The age at presentation is between 5 months and 11 years, with 11 or 12 patients presenting at less than 5 years of age. There were three patients who have been symptomatic since birth. A small accidental mucosal perforation occurred in one of the patients who underwent Nissen’s fundoplication. The perforation was closed with Vicryl. On the 3rd POD, the patient developed an intraperitoneal leak and was taken up for an immediate laparotomy. The fundoplication was dismantled, the perforation was repaired, and Thal’s procedure was done. The postoperative recovery was uneventful. In another patient who underwent. Thal’s fundoplication had an accidental mucosal perforation, which was uneventful. In 1 patient, relaparotomy was done, Nissen’s wrap was dismantled, and Thal’s wrap was applied. The other patient did not come for a follow-up. The other 2 patients with Nissen’s procedure showed symptomatic relief in the long-term follow-up. All the cases who underwent Thal’s procedure have shown relief of symptoms within the first 3 months of follow-up, with good weight gain without reflux. A barium oesophagogram done 6 months after the procedure showed a decrease in the size of the lower end of the oesophagus with no evidence of GER. No mortality was recorded. Conclusion: Thal’s findoplication shows 100% efficacy in preventing GERD and relieving symptoms following Heller’s esophagocardiomyotomy and proved to be an effective procedure in comparison with Nissen’s fundoplication. In cases of accidental mucosal perforation, Thal’s wrap is a better procedure for preventing leaks.