Objective To compare the value of NBI with magnify endoscopy (NBI-ME) and Lugol chromoendoscopy (LCE) in preoperative assessment of early esophageal cancer, and assess whether the former can replace the latter. Methods 59 patients, sampled in the Second Hospital of Lanzhou University, the First Hospital of Lanzhou University and the Second Hospital of Lanzhou City from January 2014 to December 2015, were examined respectively by NBI-ME and Lugol chromoendoscopy not only to distinguish the lesion boundaries but also predict the pathological types as well for statistical analysis with the combination of the final postoperative pathological results. Results Only 64.4 % (38/59) of lesion boundaries can be well-distinguished by NBI-ME, which is significantly lower than that distinguished by Lugol chromoendoscopy (91.5 %, 54/59), with its kappa value 0.208 < 0.4, P < 0.01 (0.006). It indicated that poor concordance existed in these two methods. The McNemar value which reflects concordance between pathological type predicted by NBI-ME and postoperative pathology was diagnosed to be 5.397, P > 0.05 (0.369), Kappa > 0.4 (0.429), P < 0.01 (0.000), suggesting the concordance can be acceptable. However, the McNemar number diagnosed by Lugol chromoendoscopy was only 4.533, P > 0.05 (0.475), Kappa < 0.4 (0.286), P < 0.01 (0.001), showing the poor concordance instead. Conclusions To some extent, pathological type predicted by NBI-ME indeed had an concordance with postoperative pathology, which was also superior to the results examined by Lugol chromoendoscopy, while there was no denying that Lugol chromoendoscopy had an obvious advantage over NBI-ME in terms of distinguishing lesion boundaries, therefore, it can not be completely replaced with NBI-ME at present.