The prognosis of esophageal carcinoma is closely related to tumor stage and treatment modalities are applied according to the TNM stage of the disease and the performance status of the patient. Selecting the appropriate treatment based on accurate staging is of paramount importance. The subject of this review concerns advances in pretherapeutic assessment of esophageal carcinoma. Advantages and limits of pretherapeutic examinations are exposed with special interest to endoscopic and radiological investigations (sonography, computed tomography, magnetic resonance imaging, PET-scan, endoscopic ultrasonography, bronchoscopy.). Impact on therapeutic management is clarified.