Functional dyspepsia manifests as epigastric pain, burning sensation, postprandial fullness, and bloating in the upper abdomen, among other symptoms. Gastroparesis is defined as a condition of delayed gastric emptying without mechanical obstruction associated with clinical symptoms. Symptoms are usually related to meal ingestion and typically include nausea and vomiting as cardinal symptoms, but also a feeling of fullness and upper abdominal pain. The most common triggers of this condition are diabetes mellitus (type 1 > type 2), postoperative defects, and gastrointestinal infections. In most cases, the etiology remains unknown (idiopathic gastroparesis). Overall, gastroparesis is associated with significantly reduced quality of life and (depending on underlying disease and comorbidities) increased mortality. Gastroparesis and dyspepsia cannot be clearly distinguished by clinical criteria. However, functional dyspepsia and gastroparesis are different entities regarding therapy and prognosis. Treatment consists of stepwise escalation depending on the severity of symptoms and is guided by treatment response. However, management of affected patients can be difficult in everyday clinical practice. In particular, this concerns the availability of longer-term effective medications with few side effects. Gastric emptying scintigraphy is considered the gold standard for diagnosis of gastroparesis and most widely used. It allows assessment of gastric function visually and quantitatively (emptying and peristaltic activity of the stomach). Measurements of pyloric resistance (EndoFLIP™, Medtronic, Meerbusch, Germany) allows evaluation of the pylorus and is important when innovative interventional treatment options are used (gastric peroral endoscopic myotomy, G‑POEM).