A case of primary carcinoma of the esophagus is presented that consisted of poorly differentiated small-cell carcinoma. The patient underwent endoscopic treatment, first with an Nd:YAG laser and, finally, with bougienage and the insertion of a prosthesis in order to relieve dysphagia and improve the nutritional status and quality of life. Even though it is generally uncommon for laser therapy to be chosen as a primary mode of treatment, the results obtained should permit to overcome this lack of confidence in the choice of laser treatment for small-cell carcinoma of the esophagus.