The screening for malignancies involving the upper gastrointestinal (GI) tract has taken on new importance as the incidence of cancers such as adenocarcinoma of the esophagus has risen. The availability of new screening technology and molecular biological techniques has dramatically improved our ability to detect early lesions. We have also developed a detailed understanding of the natural history of many upper GI malignancies. This new knowledge has led to significant improvement in population-based screening programs. In this review we will detail the evidence supporting our current screening methods and provide a concise overview of current screening recommendations for select upper GI malignancies.