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Collis-Belsey fundoplication is a surgical procedure primarily performed to treat gastroesophageal reflux disease (GERD) and associated complications. This technique involves a combination of two essential procedures: a Collis gastroplasty and a Belsey fundoplication. The Collis gastroplasty portion is necessary when the patient has a shortened esophagus due to reflux or other conditions, leading to inadequate anti-reflux barriers. In this step, the surgeon elongates the esophagus by mobilizing it and resecting a portion of the stomach, facilitating better alignment of the stomach and esophagus. The Belsey fundoplication component then follows, where the upper portion of the stomach, or fundus, is wrapped around the lower esophagus. This wrap creates a new valve mechanism that prevents the backflow of stomach contents into the esophagus, thereby alleviating reflux symptoms. Typically conducted via laparoscopic techniques, Collis-Belsey fundoplication requires specialized skills to ensure an effective outcome while minimizing postoperative complications. Patients generally undergo preoperative assessments to evaluate their health status and suitability for this surgery, often involving imaging studies, esophageal function tests, and consultations regarding other treatments previously attempted for GERD. The recovery process usually entails a hospital stay of a few days, followed by several weeks of dietary modifications to allow the surgical sites to heal adequately. Patients are generally advised to start with soft foods and gradually reintroduce solid foods as tolerated. The expected outcomes of the Collis-Belsey fundoplication procedure are significantly improved control of acid reflux symptoms, reduction in medication requirements for GERD, and enhancements in the quality of life. However, as with any surgical intervention, risks such as infection, difficulty swallowing, and esophageal injury, while relatively rare, must be discussed with the patient beforehand. Long-term success rates are generally favorable, but lifestyle modifications and regular follow-ups remain essential for optimal management of GERD after surgery. Due to the nature of the procedure, it is most beneficial for patients with both anatomical changes to the esophagus and severe GERD symptoms resistant to medical treatment. The combined approach of Collis gastroplasty with Belsey fundoplication thus addresses both structural and functional components of gastroesophageal reflux, providing a comprehensive solution to a challenging condition. Overall, this surgical option represents a significant advancement in the treatment of GERD, especially for those patients with complex presentations requiring a tailored surgical strategy to restore anatomical integrity and function.