Eosinophilic esophagitis (EE) is a recent diagnosis of growing prevalence which must be considered in children and adult patients, more often in male. EE is a chronic, immune/antigen-mediated, and esophageal-limited disease characterized by eosinophil-predominant inflammation. EE should always be considered in any impaction or dysphagia, but the spectrum of clinical manifestations is broad including manifestations of gastro-esophageal reflux disease resistant to anti-secretory. The endoscopic appearance alone can be misleading and only histological examination can confirm the diagnosis by showing infiltration of the esophagus with eosinophils. In other cases, drug therapy is based on inhibiting the proton pump and topical steroids aimed at controlling inflammation to prevent progression to fibrosis and esophageal strictures.