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Introduction: Disparities in outcomes of surgical procedures are well-recognized and extremely important. This study examined the impact of race, age, and gender on outcomes of adult laparoscopic reflux surgery (LRS).Methods: University HealthSystem Consortium (UHC) is an alliance of over 100 academic medical centers and affiliate hospitals. UHC’s Clinical DataBase/Resource Manager (CDB/RM) allows comparison of patient-level risk-adjusted outcomes for performance improvement. A retrospective analysis of discharge data (2006-09) of adult LRS for esophagitis and esophageal reflux was performed using UHC database CDB/RM. Discharge data from the UHC database was accessed using International Classification of Diseases (ICD-9) codes. Principal outcome measures analyzed were mortality, morbidity, 30-day readmission, intensive care unit (ICU) admission, length of ICU stay, length of stay (LOS) and costs. Results: A total of 8,941 patients were included in the study. Race and age-related differences in LRS outcomes were observed. Compared to Caucasians, Hispanics had equivalent LOS and African-Americans showed significantly higher LOS (2.90 ± 4.97 days for Caucasians vs. 4.33 ± 10.71 days for African-Americans vs. 3.06 ± 4.13 days for Hispanics; p<0.05). In addition, African-Americans showed significantly higher overall morbidity (12.66% for Caucasians vs. 15.83% for African-Americans; p<0.05) and hospital costs ($12,131 ± 17,341 for Caucasians vs. $16,165 ± 35,420 for African-Americans; p<0.05). Overall morbidity due to LRS progressively increased with age from 9.62% in 18-30 years group to 17.53% in the >65 years group. No significant gender differences in overall morbidity (12.72% for male vs. 12.60% for female; p>0.05), length of stay (2.87 ± 5.74 days for male vs. 3.04 ± 5.23 days for female; p>0.05) or costs (12,389 ± 20,892 for male vs. 12,136 ± 17,004 for female; p>0.05) for LRS were observed.Conclusions: This study showed race and age-related differences in outcomes of LRS. African-American patients showed relatively poor surgical outcomes and a more complicated post-operative course. With increasing age, a trend towards increased overall morbidity was observed. Thus, patient race and age appear to have an impact on outcomes of laparoscopic reflux surgery.