Oesophageal scintigraphy has been used for more than 25 years and allows quantifiable, safe, rapid, non-invasive and well-tolerated assessment of oesophageal transit time and function. As technology improves, more complex image analysis is becoming possible. Many studies have addressed its usefulness in assessing oesophageal dysmotility using manometry as the gold standard: this literature is reviewed with reference to both the sensitivity and the specificity of the test as well as its application and effectiveness in various disease states. The use of scintigraphy in oesophageal cancer is specifically addressed - including in co-existing dysmotility.