Most cases of superficial esophageal cancer have been reported in Japan and China. Radiological findings in 11 patients (13 lesions) are described. Superficial spreading cancer is difficult to detect despite widespread mucosal involvement. Double-contrast technique is essential, both to detect lesions and to demonstrate their extent. An irregular, rigid wall, mucosal abnormalities such as barium pooling and coating, and protrusions of various sizes and shapes are diagnostic features.