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Background/Aims Gastro-esophageal reflux disease questionnaire (GerdQ) has been developed for diagnosis of gastro-esophageal reflux disease (GERD). Recently published Lyon GERD consensus defines parameters on esophageal testing that conclusively establish the presence of GERD. However, Lyon GERD consensus criteria was not validated in Asian population. Therefore, we aimed to validate the Lyon GERD consensus criteria using GerdQ. Methods Patients with suggestive GERD symptoms were enrolled in the study. They underwent pH monitoring, upper endoscopy and asked to GerdQ between January 2018 and July 2019. Patients previously treated with surgical or endoscopic treatment were excluded. The results of pH monitoring and endoscopic grade of esophagitis were analyzed according to the Lyon consensus criteria. Results A total of 181 patients (male:female, 71:110; median age, 57 years) were included and 114 patients (63.0%) had GerdQ score over 8. On the pH monitoring, 13.8% of patients had acid exposure time (AET) over 6%, 7.2% had AET 4% to 6%. On endoscopic finding, 0.6% patients had grade C or D esophagitis; 13.2% had grade A or B esophagitis; and 1.1% had Barrett's esophagus. By Lyon consensus, 26 patients (14.4%) were classified as conclusive evidence of GERD, 102 patients (56.3%) were against GERD, 50 patients (27.6%) were borderline or inconclusive, and three patients (1.7%) were adjunctive or supportive. The GerdQ was not correlated with Lyon consensus criteria (rho=-0.050, p=0.507) but positively correlated with endoscopic esophagitis grade (rho=0.236, p=0.001). Conclusions Despite high rate of GerdQ over 8, proportion of conclusive evidence of GERD and higher grade of reflux esophagitis were low. GerdQ and Lyon consensus criteria showed poor correlation to each other. The development of criteria suitable for Korea's situation is warranted. [ABSTRACT FROM AUTHOR]