Endoscopic submucosal dissection (ESD) is a mainstream treatment for superficial pharyngeal squamous cell neoplasms (SPSCN) in Japan. There were few reports of it in China, which were small in scale and lack long-term follow-up data. Quality of life (QoL) outcomes of ESD for SPSCN have also not been studied. The aims of this study were to clarify the safety and efficacy of ESD for SPSCN and its outcomes in the Chinese setting.Eighty-four consecutive patients with 145 lesions treated with ESD for SPSCN from January 2014 to August 2022 were enrolled. Their curability, complications, metachronous SPSCN, local recurrence, lymph node metastasis, and overall and disease-specific survival rates were analyzed. The quality of life was measured by MD Anderson Symptom Inventory-Head and Neck (MDASI-HN).The en-bloc resection rate was 94.5%, and the R0 resection rate was 74.5%. The postoperative adverse event rate was 2.6%. The median follow-up period was 36.28 months. The 3-year rates of metachronous pharyngeal cancer, local recurrence, lymph node metastasis, overall survival, and disease-specific survival were 14.1%, 7.6%, 9.6%, 92.4%, and 98.0%, respectively. The mean symptom composite score and interference score of MDASI-HN were 10.3 and 2.3, respectively.In the Chinese setting, pharyngeal ESD achieves curability, safety, and long-term outcomes comparable to those observed in Japan. The postoperative QoL is satisfactory.