High Resolution Manometry (HRM) was the concept and innovation of a remarkable esophagologist, researcher and educator, the late Ray Eugene Clouse, MD. HRM has its roots in conventional perfused manometry. Clouse decided that the esophagus was holding secrets between the widely spaced recording points of conventional manometry catheters. A collaboration between Ray Clouse, Medical Measurement Systems and Dentsleeve in 1995, resulted in the development of the Clouse Contour Plot, an HRM solution using a 21 channel silicone water perfused catheter, and a UPS-2020 manometry system from MMS*. Because of the availability of new catheter technologies, smart perfusion systems and faster computers, HRM is becoming the standard to diagnose swallowing disorders and measure pressures in the esophagus.