Barrett's esophagus has become a very important topic in gastroenterology. Its management may vary from essentially a surveillance strategy to highly invasive esophagectomy. The variation in management strategies has occurred because of the current perceptions regarding cancer risks, which range from almost negligible to an incidence of 30% in high-grade dysplasia. Although it is clear that most patients with Barrett's esophagus without dysplasia will not require therapy, the prospect of continued surveillance is unpleasant at best. Promising future tools and techniques for surveillance and treatment are described in this review.