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Abstract  Limited epidemiologic information is available on achalasia in Northern European countries and worldwide. Achalasia has never been studied in Iceland. This study aimed to evaluate the epidemiology of achalasia in Iceland and compare the findings to other studies. All patients diagnosed with achalasia in Iceland from 1952 to 2002 were identified and patients demographic and clinical history was reviewed. The incidence and prevalence of achalasia were obtained. Sixty-two achalasia patients were diagnosed during the 51-year study period, 33 males and 29 females. The mean age at diagnosis was 45.2 years (range, 13.2–85.4 years). The median duration of symptoms before diagnosis was 2.0 years. The mean prevalence was 8.7 cases/100,000 and the overall incidence was 0.55 case/100,000/year. This is the first national epidemiological study of achalasia in a genetically homogeneous population, spanning over half a century. The epidemiology of achalasia in Iceland is similar to that in most other reported studies. [ABSTRACT FROM AUTHOR]