Abstract: Objectives To analyze the clinical and pathological characteristics of esophageal submucosal tumors (ESMTs), and evaluate the safety, economy and efficacy of endoscopic diagnosis and therapy for ESMTs, on account of endoscopic technique. Methods 98 patients with ESMTs were selected from January 2012 to December 2017 by endoscopy and ultrasonography; they were all treated by endoscopic therapy and pathological examination was took in all removed tumors. Result In 98 cases, 55 cases are female patients, accounting for 56.12%; the tumors located at the upper third of the esophagus accounted for 27.55% (27/98), at the middle esophagus for 28.57% (28/98), at the lower esophagus for 43.88% (43/98). 56 cases were treated by endoscopic submucosal dissection, 25 by endoscopic submucosal excavation, 12 by submucosal tunneling endoscopic resection, 3 by endoscopic polypectomy, and the rest 2 were changed to surgical treatment or thoracoscopic surgery because one solitary fibrous tumor was found the basilar part was too deep during the operation and another tumor was found to be too big and difficult to dissect by endoscopy; 1 schwannoma occurred post operative pleural effusion, pneumothorax, fistula and stenosis, 1 leiomyoma treated by thoracoscopy occurred pleural effusion, pneumothorax, another 2 occurred mediastinal and emphysema subcutaneous and got better spontaneously after 2?~?3 days; after pathological and immunohistochemical analysis, 90 tumors were identified as esophageal leiomyoma, which were the most common ones, accounting for 91.84%. Conclusion Most ESMTs are found in female, and are commonly located at middle and lower esophagus and most of them are leiomyoma according to the results of pathological test. It can make more accurate diagnosis in terms of different origin layers and property of esophageal tumor by endoscopic ultrasonography (EUS). Endoscopic therapy is safe and effective, and meanwhile, it can provide integral pathological information.