The last decade has seen a transformation in the endoscopic management of Barrett's esophagus associated dysplasia from simple surveillance to therapeutic tissue eradication. The combined approach using endoscopic mucosal resection and ablative techniques has proven to be safe and effective. This strategy provides a more cost-effective and safer alternative to esophagectomy for patient with high-grade dysplasia. Despite its safety and efficacy, many questions remain regarding durability, complications, and risk-stratification of patients for endoscopic therapy. However, endoscopic therapy provides a safe and effective weapon against the rising incidence of esophageal adenocarcinoma.