Aim. To investigate the frequency of extraesophageal syndromes in elderly patients with gastroesophageal reflux disease (GERD). Subjects and methods. This cross-sectional study was conducted to compare the clinical manifestations of GERD in 1100 patients aged 60 to 75 years and in 453 patients aged 36 to 60 years. A control group consisted of 154 elderly patients without GERD and 178 mature-aged patients without this condition. GERD was diagnosed via analysis of its symptoms, esophagogastroduodenoscopy, and 24-hour pH monitoring on the basis of the Montreal consensus guidelines. Extraesophageal syndromes were detected actively using the current methods accepted to treat lung, heart, and ENT diseases and a simultaneous gastroesophageal examination. Results. Chronic cough, asthma, chronic laryngitis, cardialgias and cardiac arrhythmias were much more common in elderly patients with GERD than in those without this condition and prevalent in patients with erosive esophagitis and Barrett’s esophagus as compared with those with non-erosive reflux disease. The mature-aged patients were recorded to have similar but less pronounced trends. The authors proposed an algorithm for the management of patients with extraesophageal manifestations of GERD, the important aspect of which was two-month acid-suppressive therapy used as both diagnostic testing and empirical treatment for this pathology. Conclusion. The extraesophageal manifestations of GERD in elderly patients are a serious clinical problem calling for considerable attention.