Fifty-four patients having antireflux surgery (20 fundoplication alone [group 1] and 34 fundoplication with proximal gastric vagotomy [group 2], had their gastric emptying assessed preoperatively and postoperatively. At 3 years after operation, in group 1, the emptying of a solid meal was significantly accelerated. In contrast, no such acceleration in solid emptying was observed in group 2. Liquid emptying was significantly accelerated in both groups of patients postoperatively. No consistent relationship was found between symptomatic outcome and gastric emptying in either group of patients. We conclude that proximal vagotomy interferes with reflex pathways that are involved in the acceleration of solid gastric emptying after fundoplication.