Oesophageal achalasia is a neuromuscular disorder of unknown aetiology, characterised by abnormal motility of the oesophagus and failure of the lower oesophageal sphincter to relax. This causes an abnormal dilatation of the oesophagus and resultant symptoms of vomiting/regurgitation, dysphagia, chest pain and at times, signs of lung aspiration and infection. In children, it may present as a chronic cough. The condition usually presents in the 4th and 5th decades and has very rarely been described in children. We describe two cases of achalasia and their imaging findings in adolescents.