BACKGROUND/AIMS: In adult patients with dysphagia, food impaction and non-responsiveness to proton pump inhibitor, eosinophilic esophagitis (EoE) should be considered. We aimed to investigate the prevalence of EoE in Korean patients. METHODS: From July 2007-February 2009, 108 patients presenting with dysphagia and reflux related symptoms were enrolled. The mid-esophageal region was randomly biopsied. RESULTS: Of the 108 patients, two cases of EoE, two cases of eosinophilic enterocolitis and one case of drug-induced eosinophilic enterocolitis were diagnosed. The most frequent symptom was dysphagia (37.9%), followed by epigastric pain (25.9%) and regurgitation (23.1%). Endoscopic findings of eosinophilic infiltration in the esophagus were ring esophagus, linear furrow, nodularities and whitish patches. Histologic findings showed chronic inflammation (33.3%), epithelial cell hyperplasia (16.6%), eosinophilic infiltration (3.7%) and a few eosinophil infiltration (1.8%). CONCLUSIONS: EoE was detected in 1.8% in Korean patients with dysphagia and reflux related symptoms. Esophageal random biopsy should be considered especially in young patients with a history of allergic disease and esophageal symptoms.