Esophageal bulge with smooth surface is considered to be related to esophageal polyps, esophageal cysts, lipomas, esophageal mesenchymal tumors and so on. 1. Esophageal polyps: the etiology is still unclear, may be related to local chronic inflammation, genetic factors, etc., often accompanied by dysphagia, retrosternal pain, chest tightness, shortness of breath and other uncomfortable symptoms. Barium esophagography can show polyps with smooth boundary, ultrasonic endoscopy can show elevated mucosa or submucosa, and the mucosa is intact and the hierarchical structure is normal. 2. Esophageal cysts: Esophageal cysts are associated with congenital factors, chronic esophagitis, glandular obstruction, etc. They are easily accompanied by symptoms such as dysphagia, nausea and vomiting, and emaciation, etc. Some of the esophageal cysts with small size have no obvious symptoms. X-ray barium meal contrast examination shows smooth mucosal surface, and esophageal ultrasonic endoscopy shows intact mucosal band, clear boundary, and no adhesion with surrounding tissues. 3. Lipoma: the etiology is still unclear, which may be related to genetic factors and abnormal fat metabolism. Patients may have abdominal pain, dyspnea and other uncomfortable symptoms, and the surface of esophageal bulge can be seen smooth in medical examination. 4. Esophageal mesenchymal tumor: the cause of the disease is still not completely clear, may be related to poor dietary habits, genetic factors, etc., and may also be manifested as smooth surface of esophageal bulge. Common symptoms include dysphagia, retrosternal pain, chest tightness, belching, acid reflux and abdominal pain. It is recommended that those who have smooth surface of esophageal bulge do further detailed examination, clarify the cause of the disease under the guidance of professional physicians, and follow the doctor’s instructions for treatment.