The foregut is at the forefront of intestinal transit and motility as well as digestion and absorption. Thus the manipulation of these processes during the treatment of disease, both medically and surgically, allows for both treatment success and treatment consequences. This chapter will review the various methods for the evaluation of esophageal and gastric transit, motility, acid physiology, as well as anatomic considerations and evaluations. It will review the basic procedural elements to each testing method and review salient features to each test.