Transcutaneous ultrasound of the cervical esophagus was performed in 46 patients with esophageal carcinoma and in 35 controls. The former had 24 upper segmental lesions and 22 lower segmental lesions. The level of the sternoclavicular joint was used to divide the esophagus into the upper segmental (USE) and lower segmental esophagus (LSE). The anterior esophageal wall thickness and luminal dimensions were measured before and immediately after phonation. The mean wall thickness in the controls was 1.8 mm before phonation and 2.1 mm after phonation, with a significant difference (t test, P < 0.05). The mean wall thickness in the USE carcinoma group was 4.3 mm and 4.4 mm before and after phonation respectively. There was a significant difference between the controls and USE carcinoma groups (t test, P < 0.05). The cross sectional area, which was calculated as the product of anterio-posterior and lateral diameters, averaged 28 mm2 before phonation in the controls and increased to 44 mm2 after phonation (t test, P < 0.05). The mean cross sectional area in the USE carcinoma group was significantly smaller before phonation than that in the controls (t test, P < 0.05) and showed little change after phonation. No significant difference was found between LSE carcinoma and control groups. Transcutaneous ultrasound appears to be a promising non-invasive method of investigation for cervical esophageal carcinoma.