Syringomyelia is a rare degenerative disorder of the spinal cord that causes progressive neurological dysfunction. Patients with syringomyelia have a variety of gastrointestinal symptoms although there are limited data on the frequency or the severity of these complaints. In this case report we describe a 65-yr-old man with syringomyelia and gastrointestinal dysmotility at multiple levels as documented by esophageal motility study, gastric emptying scan, antroduodenal motility study, and anorectal manometry. The patient's nausea, recurrent vomiting, and fecal incontinence were treated successfully with dietary changes, a promotility agent, and a bowel training regimen. This report highlights the need for more objective studies of gastrointestinal motility in patients with syringomyelia.