Surgery remains the main stay in the treatment of carcinoma of the esophagus and the results of surgery for esophageal cancer have improved over the past 10 years. The ideal operation for cancer of the esophagus should have good palliation, low morbidity and mortality, and optimize both long-term function and survival. The two main approaches currently used for surgical treatment of esophageal cancer are: transthoracic esophagectomy (TTE) and transhiatal esorhagectomy(THE). The advantages of THE are low morbidity and mortality, short operating time, a short hospital stay and low interference with respiratory physiology The selection criteria for this procedure may differ but there are two situations which could clearly benefit from THE; these are epithelial and superficial submucosal lesions, particularly in cases of multiple lesions, and any resectable tumor at any stage with poor clinical status. I reviewed the selection criteria, surgical procedures, and results of THE in esophageal cancer with the literatures.