〔Abstract〕 Objective To evaluate the indication and efficacy of ESD in the treatment of early esophageal squamous cell carcinoma by analyzing the clinicopathological features and short-term outcome of endoscopic submucosal dissection(ESD) in the treatment of early esophageal squamous cell carcinoma. Methods This study retrospectively analyzed the general clinical data, ESD treatment, histological and pathological results of resected specimens and follow-up results of patients with early esophageal squamous cell carcinoma treated with ESD. Results It was found that the lesion size, the circumference of the lumen, the depth of invasion and the resection margin were related to lymphovascular invasion(LVI).Multivariate analysis showed that the circumference of the lumen and the depth of invasion were independent risk factors for LVI.The en bloc resection rate was 100.00%(328/328),the complete resection rate was 94.51%(310/328),and the curative resection rate was 89.33%(293/328).The postoperative complications were as follows: delayed bleeding 0.75%,esophageal stenosis 4.49%,and no perforation occurred.The overall recurrence rate was 0.75%(2/267).A total of 23 patients underwent additional surgery or adjuvant treatment after ESD.There was not any additional treatment in group A(pCurA),radiotherapy was the main additional treatment in group B(pCurB),and surgery was the main additional treatment in group C(pCurC). Conclusion For patients with early esophageal squamous cell cancer whose depth of invasion do not exceed SM1 and there is no lymph node metastasis, ESD is safe and effective, and can be used as the first choice for treatment.Patients with lesion circumference ≥3/4 or deep invasion are independent risk factors for LVI,which should be paid attention to in preoperative evaluation.In postoperative evaluation, patients with pCur A or pCur B should be closely followed up, while patients with pCur C should be actively supplemented with surgery or adjuvant treatment.