Minimally invasive esophagectomy (MIE) has become an established approach for the treatment of esophageal carcinoma. In comparison with open esophagectomy MIE reduces blood loss, respiratory complications, and length of hospital stay. At the University of Pittsburgh, the authors now predominantly perform a laparoscopic-thoracoscopic Ivor Lewis esophagectomy. This article details this technique, discusses the recently published series of more than 1000 esophagectomies performed by the authors during the last 15 years, and reviews the current literature on MIE.