Endoscopy together with endoscopic ultrasonography (EUS) are the most important diagnostics for esophageal cancer and staging of the primary. The results have important clinical consequences concerning type of resection or multimodal approach. Further refinements of endoscopy will increase its significance 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.