The need for surgery for esophageal squamous epithelial hyperplasia depends on the extent of the hyperplastic lesion. The normal esophageal epithelium is squamous epithelium, and after gastroscopic biopsy, if it suggests that the squamous epithelial hyperplasia is only an inflammatory hyperplasia or a mild hyperplasia, we do not need to panic too much. If the pathology suggests moderate or severe hyperplasia, close follow-up must be performed. Because moderate to severe hyperplasia or even anomalous cells suggest precancerous esophageal lesions, it is important to prevent the appearance of cancer and early endoscopic intervention and esophageal ESD surgery to prevent the development of progressive esophageal cancer. Squamous hyperplasia is mainly caused by some irritating factors of esophageal epithelium, such as rough food, injury by too cold or too hot food, some inflammation, stomach acid and so on. Therefore, after the appearance of esophageal squamous epithelial hyperplasia, there is no need to panic too much, and timely endoscopic follow-up can be performed to provide timely diagnosis and treatment by a specialist according to the pathological condition.