Recent advances in non-surgical treatments such as endoscopic mucosal resection (EMR) and chemoradiotherapy (CRT) have provided various advantages with clinically meaningful impacts in the treatment of esophageal cancer. EMR is a standard treatment for mucosal cancer and is being investigated for use in combination with CRT for submucosal cancer. Definitive CRT has also reported to results in survival mostly comparable with surgery in the loco-regional stage. A randomized trial comparing surgery alone with definitive CRT in stage I disease is also planned. In patients with T4 disease, it appears that CRT is becoming a standard. However, various issues and limitations remain with non-surgical treatments. To improve treatment results, closer collaboration between surgeons and radiation oncologists is necessary.