Abstract: The development and management of gastroesophageal reflux disease (GERD) after bariatric surgery remain a formidable clinical challenge. Post‑operative GERD arises from a complex interplay of anatomical and functional alterations, including elevated intragastric pressure, intrathoracic sleeve migration, impaired lower esophageal sphincter function, and hiatal herniation. Accurate characterization of these mechanisms is a prerequisite for evidence‑based therapeutic decision‑making. Effective management of post‑bariatric GERD hinges on the rational integration of multiple diagnostic modalities. Current practice lacks a stratified assessment strategy tailored to individual pathophysiology; reliance on symptoms and conventional endoscopy alone frequently underestimates the true burden of reflux, complicating timely diagnosis. Herein, the authors synthe-size contemporary international consensus statements with clinical experience to propose a compre-hensive GERD evaluation framework after bariatric surgery. We advocate a stepwise algorithm that progresses from subjective symptom profiling to objective corroboration, and from morphologic imaging to functional validation. By embedding structured screening, anatomic mapping, and physio-logic testing into a unified diagnostic pathway, clinicians can deliver personalized, precision assess-ments that optimize therapeutic selection, improve surgical outcomes, and enhance long‑term quality of life.