Although the possible existence of micrometastasis in superficial esophageal cancer cases is the most important factor in deciding the therapeutic strategy, it is difficult. There are also limits to the diagnosis of the depth of tumor invasion by endoscopy and EUS. Therefore, the extension of the indication of EMR is planned. Then, the complement of diagnostic ability by EMR is being tried. Sentinel lymph node (s) identification and its biopsy also seem to be useful. In advanced esophageal cancer cases, diagnostic accuracy has been improving by speedup of CT and MRI scans and various image processing technology. More accurate diagnosis of metastasis using PET is much awaited. However, there is still insufficient ability to detect micrometastasis to date. Molecular bio-markers with comprehensiveness are not a valuable selection at this stage. Although advanced equipment has brought more diagnostic accuracy, ways to integrate or use these tools at the clinical level are sought. Some equipment developing and how to integrate them and how to select the appropriate examination in each patient are problems which are required in clinical practitioners.