Aims Endoscopic submucosal dissection (ESD) has been recommended as a local curative approach for early squamous esophageal neoplasms including low-grade intraepithelial neoplasia (LGIN),high-grade intraepithelial neoplasia (HGIN), or intramucosal carcinoma (IMC).However, local recurrence and metachronous lesions are still the major problem with ESD.Therefore, we performed a prospective study to assess the efficacy and safety of ESD for early squamous esophageal neoplasms and to provide long-term follow-up data of ESD based on a large series of patients.