Esophageal carcinoma is a highly aggressive malignancy with significant morbidity and mortality, often diagnosed at advanced stages. This chapter provides a thorough exploration of the comprehensive management of esophageal cancer, including diagnosis, pathology, and treatment strategies. It begins with an overview of the clinical presentation, diagnostic workup, and staging methods, highlighting the importance of imaging and endoscopic techniques in early detection. The pathology section delves into the histopathological subtypes of esophageal cancer, including squamous cell carcinoma and adenocarcinoma. Surgical treatment, including esophagectomy, is discussed alongside its indications, techniques, and post-operative care. Chemotherapy and radiation therapy, including external beam radiation and brachytherapy, are examined as primary and adjuvant treatments, emphasizing their roles in managing advanced disease and enhancing survival. The chapter concludes with insights into multimodal treatment approaches, current challenges, and future directions in esophageal cancer care, aiming to improve patient outcomes and quality of life.