Esophageal pH-resistance monitoring reflects the nature and movement of the bolus by recording the impedance changes caused by the passage of the bolus in the esophageal lumen. It compensates for the weak point of weak acid and non-acid reflux caused by esophageal pH monitoring and wireless pH capsule detection, which improves the sensitivity of detecting reflux events and increases the value of reflux detection. Esophageal pH-impedance monitoring can be monitored without deactivating proton pump inhibitors in some cases. Traditional indicators such as acid exposure time and DeMeester score are the main indicators in the diagnosis of gastroesophageal reflux disease (GERD), especially in gastroesophageal reflux disease with acid reflux. However, esophageal pH-impedance monitoring improves the detection rate of reflux-related symptoms and reflux events, and improves the detection sensitivity of GERD. New impedance-based indicators such as: postreflux swallow-induced peristaltic wave and esophageal baseline impedance improve pH-impedance monitoring in refractory gastroesophageal reflux disease, functional heartburn, reflux high sensitivity, and GERD-related extra-esophageal symptoms Clinical diagnostic value, This article describes the clinical application of esophageal pH-impedance monitoring in order to better use esophageal pH-impedance monitoring to assist in the diagnosis of esophageal diseases.