The management of benign esophageal strictures is challenging. The first strategy includes endoscopic dilation using bougies or balloons. Although the immediate success rate of these is up to 90%, about 30-40% of patients experience recurrent dysphagia within the first year of follow-up. The management of refractory stenosis involves repeated sessions of endoscopic dilation. In order to obtain long-lasting functional results, alternative treatments have been developed, such as the use of self-expanding stents, particularly indicated in subgroups of patients with post-surgical stenosis or post-radiation therapy. If this approach fails, other possibilities are represented by self-decoding, PEG/J-tube positioning and, finally, reconstructive surgery.