For all patients with esophageal cancer, the five-year survival rate is about 20%. The two most common histopathologic subtypes of esophageal cancer are squamous cell carcinoma and adenocarcinoma. This chapter focuses on the epidemiology, pathogenesis, clinical presentation and diagnosis, staging, and endoscopic therapies for malignant esophageal cancers. The epidemiology of esophageal cancer has changed significantly over the last 40 years, with adenocarcinoma becoming much more common than squamous cell carcinoma in the Western world. Benign esophageal tumors are rare. They are usually asymptomatic and discovered incidentally on endoscopy for evaluation for an unrelated problem. The chapter provides information on the clinical presentation, diagnosis, histopathology, and management of some of the more common benign esophageal neoplasms. Endoscopic ultrasound can assist in establishing the nature of the lesions by determining the originating gastrointestinal tract layer.