Objective To examine the feasibility, safety and efficacy of a novel method for endoscopic resection of the protrusion lesion by tunneling technique in middle and lower part of esophagus. Methods 7 male and 17 female patients (range 40 ～ 69 years old) with a mean age of (51.75 ± 9.19) years old were enrolled in this study. We provided routine endoscopic ultrasonography treatment and used the conventional surgical method and materials of endoscopic submucosal dissection (ESD). First, we opened the tunneling at the 5 cm distance away from the lesion. Then, we set up the tunnel directly to lesion, then peel the lesion. The direction of the incision, the origin and location of the lesion, resection time, size, pathology and complications was recorded at the same time. Gastrointestinal decompression tube was placed after the operation, and we will recheck it by endoscopy after 1 month, 3 months, 6 months and 12 months. Results Endoscopic ultrasonography showed that there were 6 cases originated from the submucosal layer, and 18 cases from muscularis propria. The 24 protrusion lesions had a mean size of (1.34 ± 0.64) cm (range 0.6 ～ 3.5 cm). The procedure required 65 minutes (range 30 ～ 100 minutes) at the mean time and all lesions were excised completely. Mediastinal abdominal subcutaneous emphysema was occurred in 3 people, and self-absorbed in a week. There were no severe bleeding, perforation or any complications occurred in the rest patients. At last, there was no recurrence after 12 months. Conclusion Endoscopic submucosal tunnel dissection (ESTD) showed great feasibility, safety and efficacy to the protrusion lesions of the middle and lower segment of esophagus.