Endoscopic mucosal resection (EMR) is an effective diagnostic and potentially therapeutic treatment of dysplastic Barrett's esophagus and early intramucosal esophageal carcinoma. Appropriate patient selection for therapeutic resection can follow a diagnostic endoscopic resection, and liberal use of EMR is encouraged to gain insight into the metastatic potential of any early esophageal tumor that appears amenable to EMR. EMR is a low-risk procedure; multidisciplinary groups should consider it a vital component of the staging algorithm for esophageal cancer.