Endoscopy together with endoscopic ultrasonography (EUS) are the most important diagnos- tics for esophageal cancer and staging of the primary. The results have important clinical consequences concerning type of resection or multimodal approach. Further re?nements of endoscopy will increase its signi?cance especially for early cancer. EUS has an accuracy of 80% for the primary compared to 60% for the N-staging. Therefore EUS represents the gold standard for T-staging but it is of little value for detection of lymph node metastasis. Endoscopy together with endoscopic ultrasonography (EUS) are the most important diagnos- tics for esophageal cancer and staging of the primary. The results have important contracting consequences of type of resection or multimodal approach. Further re? Nements of endoscopy will increase its signi? Cance especially for early cancer. EUS has an accuracy of 80% for the primary compared to 60% for the N-staging. EUS represents the gold standard for T-staging but it is of little value for detection of lymph node metastasis.