Compared to other endoscopic procedures, implantation of an esophageal prosthesis is a relatively invasive treatment modality. It is mainly indicated as a symptomatic therapy in patients with unresectable tumours. The indication should therefore be clearly established. Since the results of surgery and radiotherapy have improved, an objective selection of the treatment modality is only possible in an interdisciplinary set-up. Any palliative therapy is expected not only to be less risky but should be immediately effective in relieving the patients symptoms and thus improve the quality of life. Endoscopic tube implantation fulfils this requirement regarding relief of dysphagia compared with other palliative methods eg: laser/BICAP. Re-establishing a lumen for oral feeding with photo or electrocoagulation in very advanced tumours is a long and labourious path. For such cases and for fistulae, implantation of a tube is the treatment of choice.