In several publications including more than 1,000 endoscopically treated patients it could be demonstrated that endoscopic treatment of early esophageal cancer is effective and safe. A combination of endoscopic resection (ER) of early Barrett's neoplasia followed by ablation of the remaining non-dysplastic Barrett's mucosa was able to significantly reduce the rate of recurrence and metachronous neoplasia. Long-term complete remission rates of more than 95% can be achieved. Compared to esophagectomy, endoscopic treatment has only a very low complication rate and almost no mortality. Therefore, ER is the treatment of choice and recommended by several international guidelines. Esophageal resection only plays a minor role in patients with early esophageal cancer.