<p>Current data show that up to 25% of early esophageal neoplasms/dysplasias are missed during routine endoscopy. Combined with the steadily increasing incidence of esophageal cancer over the past decades, this leads to a&#xa0;high rate of post-endoscopic esophageal cancers, which are often only diagnosed at an advanced stage. Therefore, endoscopic diagnostics and treatment of esophageal cancer should aim for a&#xa0;high detection rate of early neoplasms, followed by cost-effective endoscopic resection. With the continuous improvement of high-resolution endoscopic techniques, such as the extended depth of field (EDOF) function, and the advent of a&#xa0;new era of artificial intelligence, early detection must also be optimized outside of expert centers. In the future, artificial intelligence will play an increasingly important role in both the diagnosis and treatment of esophageal cancer. Improved early diagnostics offer the chance for minimally invasive endoscopic resection, whether through endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The choice of procedure depends, among other factors, on the type and morphology of the lesion as well as on the expertise of the endoscopist. Regardless of the choice of resection method, new data suggest that the boundaries of what is possible may be expanded, so that in the future, organ preservation with subsequent close follow-up may be more strongly emphasized in therapeutic algorithms and recommendations.</p>