Although mostly accentuated in the distal esophagus, distribution of esophageal eosinophilia in eosinophilic esophagitis (EoE) seems to be nonuniform. ¹ Disease extent has been associated with disease severity and disease progression in inflammatory bowel disease. ^2,3 Whether the same holds true for EoE remains largely unknown. One recent EoE study looked at the distribution of eosinophilia, but without analyzing its potential association with treatment outcomes. ⁴ Here, we characterize the different inflammatory patterns of EoE and investigate their impact on disease presentation and disease outcome, with a particular focus on therapeutic response.