Today a number of gastrointestinal disorders that once required open surgical or percutaneous management are being managed with endolumenal therapies. This has led to an evolution of minimally invasive endolumenal approaches to many disorders. This issue reviews the progress made in the application of endolumenal therapies and not only discuss current applications but future efforts and directions for clinical investigation. Articles will focus on the scope of the problem, past management options, new endolumenal options, investigations with endolumenal therapy, current status (clinical trial results if available), and future directions.