Cancers arising from the esophagus, including the gastroesophageal junction, are relatively uncommon in the United States — the lifetime risk of this cancer is 0.8 percent for men and 0.3 percent for women, and it increases with age. The presentation is insidious; at diagnosis, more than 50 percent of patients have either unresectable cancer or radiographically visible metastases, rendering management problematic. This review discusses the pathogenesis of esophageal cancer, as well as the clinical presentation, treatment, and prognosis.