Abstract Esophageal carcinoma is one of the most fatal malignancies worldwide. It is associated with high morbidity and mortality with a steep rise in incidence in the Wes tern world. The two dis­tinct histological types of esophageal cancer are esophageal squamous cell carcinoma and esophageal adenocarcinoma. Esophagectomy remains the treatment of choice for high-grade dysplasia. Although the surgical approach can completely resect the cancer as well as affected lymph nodes, its morbidity and mortality rate is still very high. Currently, endoscopic therapy is the preferred approach for esophageal cancers limited to the mu­cosal layer, wherein the risk of lymph node metastasis is very low. The two main endoscopic therapies for early esophageal cancer are endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), along with additional endoscopic treatment techniques including photodynamic therapy, radiofre­quency ablation, and argon plasma coagulation. Recently, sever­al studies reported the latest advancements in endoscopic diag­nosis and treatment of early stages of cancer using resection and ablation techniques. Earlier detection and advance­ments in the treatment modalities for esophageal can­cer have led to improvement in the 5-year survival rate from 5% to 20%. Strictures, bleeding, and perfo­ration are the most common adverse events in post­endoscopic therapy patients. However, these adverse events can be mitigated endoscopically. Overall, en­doscopic therapy is still evolving and the current fo­cus should be placed on patient selection through multidisciplinary sittings. 

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