A review of diagnosis and treatment of esophageal cancer is presented. Symptomatic cancer of the esophagus is usually too far advanced for a cure to be offered. Alcohol and tobacco are the common risk factors of this disease. Endoscopy is the diagnostic method of choice. Management of cancer and survival of patients depend on the stage of the disease; therefore, accurate staging is vital in the diagnostic evaluation. Endoscopic ultrasound has become a powerful staging tool, and it must be complemented by conventional imaging. Surgery, chemotherapy, and radiotherapy are used in varying combinations for cure. Palliation of symptoms is important, and it is the only possible form of therapy for some patients. The therapeutic options need to be carefully considered to suit the individual needs of each patient.