Gastroenterologists and otolaryngologists commonly care for patients with laryngopharyngeal symptoms such as voice hoarseness, sore throat, throat clearing and cough. Often symptoms are reflexively attributed to gastro-esophageal reflux disease, although poorly response to traditional anti-reflux management strategies. The current paradigm to evaluate for laryngopharyngeal reflux disease highlights the role of reflux monitoring performed off acid suppression. This review discusses the indications for reflux monitoring and reviews considerations for selection and interpretation of the different modalities of reflux monitoring for diagnosis of laryngopharyngeal reflux disease: prolonged wireless pH monitoring as well as impedance-pH monitoring.