The purpose of this paper is to identify the characteristic endoscopic findings in patients with esophageal cavernous lymphangioma and assess the efficacy of endoscopic techniques in the management of this disease. We retrospectively analyzed data from 6 patients who were diagnosed with esophageal cavernous lymphangioma by endoscopy and histologic evaluation. All patients underwent endoscopic resection of the tumor at our hospital between January 2010 and June 2011. Four male and 2 female patients, with a mean age of 48.2 ± 15.2 years (range, 35 to 77 y) with esophageal cavernous lymphangioma, who underwent endoscopy followed by endoscopic resection were included in this report. The lesions varied from 0.4 to 1.2 cm in diameter, with a mean size of 0.78 ± 0.26 cm. Endoscopy revealed dilated lymphatic channels beneath the surface epithelium of the lesion in all patients. An endoscopic ultrasound revealed that all lesions were multicystic and located in the submucosal layer. Histologic examination confirmed the initial diagnosis in all patients. Endoscopy plays an important role in the diagnosis of esophageal cavernous lymphangioma, with dilated lymphatic channels beneath the surface epithelium of the lesion being a characteristic endoscopic feature. Endoscopic ultrasonography is a useful tool to differentiate cavernous lymphangioma from other esophageal tumors. Endoscopic resection of esophageal cavernous lymphangioma was safe and effective in all of the analyzed cases.