Achalasia of the cardia is a movement disorder characterized by the absence of normal peristalsis of the esophagus and abnormal relaxation of the lower esophageal sphincter. In recent years, the incidence of this disease has increased yearly, and its pathogenesis and treatment have become a research focus. Studying the pathogenesis of AC is beneficial for the treatment and prognosis of this disease. Its main pathogeneses include inheritance, nerves, immunity, viral infection, and psychology or multifactorial interactions. This article discusses the pathogenesis of achalasia cardia.