Achalasia of the cardia is a rare esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and loss of esophageal peristalsis, leading to dysphagia, regurgitation, and chest discomfort. Among various treatment modalities, laparoscopic Heller’s cardiomyotomy combined with fundoplication has emerged as a gold-standard surgical intervention. This review examines the efficacy, safety, and outcomes of this procedure in the management of achalasia, focusing on operative techniques, perioperative considerations, and long-term results. The article explores the benefits of minimally invasive approaches in reducing postoperative complications, enhancing recovery, and improving quality of life. It also discusses the role of fundoplication in preventing gastroesophageal reflux disease (GERD), a common complication post-cardiomyotomy, and compares different fundoplication techniques. Furthermore, the review evaluates patient selection criteria, success rates, and potential challenges, including recurrent symptoms and management of advanced cases. By synthesizing evidence from recent studies, this review aims to guide clinicians in optimizing surgical outcomes for achalasia patients through tailored approaches and multidisciplinary care.