Whilst the commonest operation for the treatment of gastro-esophageal reflux is the Nissen fundoplication, some patients have troublesome side effects after this procedure, and the outcome for these individuals can be "poor." Constructing an anterior partial fundoplication can minimize these problems. Such an approach is widely used following cardiomyotomy for achalasia, and it is well accepted that a "Dor" type fundoplication minimizes reflux in this context. Similar gains are possible in certain patients undergoing antireflux surgery, where reflux control is required, yet side effects need to be minimized. Long-term outcomes, 10 or more years after surgery, and the results of randomized trials now suggest that the success rate of anterior partial fundoplication is at least as good as for Nissen fundoplication, although there are tradeoffs between a risk of recurrent reflux versus a risk of side effects. In this chapter technical aspects pertinent to the creation of a satisfactory anterior partial fundoplication are described.