<p>Over recent years, endoscopic resection techniques, particularly within the field of interventional endoscopy, have advanced substantially, leading to a marked shift in the boundaries of minimally invasive therapy away from procedures that were previously managed primarily by surgery. These are accompanied by a significant expansion of the possibilities for minimally invasive interventions, an improvement of the resection results, optimization of the endoscopic access routes and instrument guidance as well as shortening of the learning curve by standardized techniques and assistance systems. Clinically relevant, in particular, are organ-preserving treatment options with oncological safety, which contribute to a reduction in morbidity and mortality, a reduction in the duration of hospitalization and a faster postinterventional convalescence. With careful patient selection these procedures can additionally improve the quality of life and potentially increase the cost-effectiveness in the healthcare system. At the same time there are still important challenges. The sometimes steep learning curve for complex endoscopic resection techniques, the management of procedure-related complications, such as perforations or hemorrhages and the confirmation of oncologically adequate resection margins necessitate profound expertise, structured training programs and a close interdisciplinary cooperation with surgery. This underlines the necessity of a continuous interdisciplinary dialogue. The implementation of interdisciplinary boards, joint training curricula and clearly defined competence profiles represents a central component a high-quality patient care.</p>