Endoscopic palliation of unresectable esophageal carcinoma includes techniques of dilation, esophageal intubation, laser ablation, and intraluminal brachytherapy. Indications, advantages, disadvantages, results, and complications of these methods are discussed. Less common techniques include electrocoagulation, chemical necrolysis, and photodynamic therapy. Prospective randomized trials comparing techniques are reviewed. The thoracic surgeon must be acquainted with several endoscopic means of palliation in order to meet the needs of the individual patient.