Abstract: Achalasia is a primary esophageal motility disorder characterized by poor relaxation of the lower esophageal sphincter and loss of normal esophageal peristalsis. Peroral endoscopic myotomy (POEM) is an endoscopic minimally invasive technique for myotomy through a submucosal tunnel of the esophagus. Since its introduction in 2008, it has been widely used in the treatment of achalasia and esophageal motility disorders due to its minimal invasiveness and favorable efficacy. With the rapid development and promotion of POEM, and to better serve clinical practice, Chinese Society of Digestive Endoscopology, Digestive Endoscopy Specialty Committee, Shanghai Medical Association and China Anti-Cancer Association Committee on Holistic Integrative Endoscopy and Laparoscopy in Diagnosis & Treatment initiated this guideline. Guided by the methods and principles of domestic and foreign guideline formulation, a team of domestic experts in endoscopy, gastroenterology, gastrointestinal surgery, anesthesiology, and related fields were jointly organized to systematically sort out high-quality domestic and foreign literature in recent years and compile this guideline. The guideline includes 48 recommendations, including POEM indications and contraindications, access conditions, preoperative preparation, intraoperative procedures, postoperative management, complications, follow-up and prognosis, and POEM learning curve, aiming to provide safe and effective POEM treatment guidance for physicians and other personnel involved in the diagnosis and treatment of achalasia. This guideline is highly practical and operational, and expected to provide scientific and standardized POEM treatment for achalasia patients in China.