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Background Endoscopic therapies for gastro-oesophageal reflux disease (GORD) are increasingly utilised to improve symptom control while minimising surgical morbidity. Stretta radiofrequency therapy and anti-reflux ablation therapy (ARAT) using APC, act via complementary mechanisms. This prospective study is first in the world to evaluate clinical outcomes following combined Stretta and ARAT therapy in select patients.Methods A prospective cohort study was conducted in patients undergoing combined Stretta radiofrequency therapy and ARAT for GORD. All patients had endoscopy, Barium study, 24 hr pH and Manometry. Patients with Hill grade 3 and endoscopy score more than 6 were included. All patients had pathological reflux with compromised Demeester score. This study provides the first in the world evaluation of the clinical impact of this combined therapeutic strategy. Reflux Symptom Index (RSI) and GORD-Health-Related Quality of Life (GORD-HRQL) scores were collected at baseline and at final follow-up. Procedural technical variables were recorded. Proton pump inhibitor (PPI) use and patient-reported satisfaction were assessed.Results Nine patients underwent combined Stretta radiofrequency therapy and ARAT with complete follow-up to December 2025. All patients were done as day cases, 8 under sedation and one under general anaesthesia. Mean RSI improved from 25.8 ± 10.0 pre-procedure to 8.8 ± 11.8 post-procedure. Mean GORD-HRQL scores improved from 55.8 ± 10.1 to 15.9 ± 22.9. Six patients (67%) met predefined responder criteria and successfully discontinued PPIs. Three patients demonstrated limited response; one was referred for surgical fundoplication. Technical success was high, with a mean of 51 of 56 electrodes achieving adequate radiofrequency energy delivery.Conclusion Combined Stretta and ARAT therapy resulted in substantial symptom and quality-of-life improvement in the majority of patients, with two-thirds discontinuing PPIs. This dual-modality endoscopic approach may enhance reflux control in carefully selected patients.