This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage the patient with dyspepsia — a case which they are likely to encounter in the future in a general practice setting. It presents the case of a 56-year-old man who has experienced worsening indigestion over the last 3 months and those 3 months ago he presented with heartburn that occurred mainly after food and at night. On examination, the patient is diagnosed with oesophageal cancer. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.