Eosinophilic esophagitis (EoE) was a chronic inflammatory condition requiring repeated endoscopic evaluations to determine therapeutic response. This resulted in substantial medical expenses and administrative hardship for affected youngsters. Adults with EoE have a low baseline impedance as assessed by multichannel pH impedance (pH-MII), consistent with poor mucosal integrity. For a study, researchers examined the association between esophageal eosinophilia (or the severity of eosinophilic infiltration) and baseline impedance in children with EoE. Investigators retrospectively identified 15 children with EoE at the hospital who had received pH-MII within 30 days of a 3-level esophageal biopsy. This group was not concurrently prescribed proton pump inhibitors and pH-MII values for reflux were minimal. The average baseline impedance of upper, middle, and lower esophageal segments was determined using baseline impedance automated analysis (RIAA) and mean nocturnal baseline impedance (MNBI) techniques. The EoE group’s upper, middle, and lower esophageal eosinophil counts were compiled. Across the length of the esophagus, children with EoE had a significantly lower baseline impedance than 30 controls who did not differ in age or reflux burden based on nonparametric testing. There was no correlation between baseline impedance and the number of eosinophils in corresponding esophageal segments. Baseline impedance might be an essential, less intrusive adjunct for monitoring therapy response in children with EoE. Larger prospective cohort studies should determine the optimally predictive baseline impedance thresholds for active and inactive illness.