The article is devoted to the description of own observations and treatment of patients with hiatal hernias. It was noted that approaches to the surgical treatment of patients with hiatal hernias require an increase in efficiency and safety, which makes this issue relevant, despite the accumulated experience of treatment. Attention is focused on endosurgical technologies in the form of laparoscopic fundoplication and laparoscopic chiatoplasty. It has been established that the main indications for surgical treatment of hiatal hernias are: severe reflux esophagitis, development of extraesophageal complications, lack of the effect from pharmacological therapy. Laparoscopic Nissen antireflux surgery in combination with crurorrhaphy meets the requirements for surgical correction of this pathology. It is effective, well tolerated by patients, has a low percentage of complications, which allows us to consider it the "gold standard".