Chronic cough is one of the most prevalent symptoms for which patients seek medical help from primary care physicians. Chronic cough can deeply and adversely affect the quality of a patient's life and poses a big challenge to the caring physician. Here we present a rare case of ”esophageal achalasia with chronic cough”, which demonstrates the importance of history taking, of a good physical examination and of CXR[In full] interpretation when managing chronic cough patients. We also illustrate the concept of patient-centered decision making as a means of improving medical care quality.