Barrett’s esophagus is a pathological change in which the squamous epithelium of the esophagus is replaced by a metaplastic columnar epithelium. The incidence of adenocarcinoma of the esophagus mostly occurs on the basis of intestinal-type metaplastic epithelium of Barrett’s esophagus, with a clinical incidence of 2%- 15%, which is 30-100 times higher than that of the general population and should be taken seriously. Patients often do not have specific clinical symptoms, but sometimes they may have symptoms of GERD. The typical endoscopic presentation of this disease is the presence of red columnar epithelium in the lower esophagus, coupled with biopsy pathology showing intestinal mucosal metaplasia in this segment, regardless of its extent. The biopsy pathology specimen is also tested for the presence and extent of heterogeneous hyperplasia (mild, moderate, or severe) and observed for carcinoma, and the biopsy should be multi-site. What should be done after confirmation of Barrett’s esophagus? If there is only intestinal type hyperplasia and no heterogeneous hyperplasia, close follow-up observation and regular endoscopy can be done once a year. If heterogeneous hyperplasia is found, the interval between endoscopies will be shortened depending on the degree of heterogeneous hyperplasia. Those with symptoms of reflux disease are given pharmacological treatment with acid-suppressing preparations and prokinetic drugs. For more aggressive treatment, endoscopic treatment is currently applied: ⒈ thermodynamic treatment, of which there are more methods, but argon ion coagulation ablation is commonly used; ⒉ mucosal resection: for patients with highly heterogeneous hyperplasia or early esophageal cancer (lesions limited to mucosa); △ photodynamic treatment: using the principle that highly heterogeneous hyperplasia or early esophageal cancer has highly absorbing photosensitizing agents to eliminate these lesions. Although this method can significantly reduce the incidence of highly heterogeneous hyperplasia and the rate of carcinoma, a significant proportion of lesions remain (about 17%) and cannot prevent recurrence, and there are many residues in Barrett’s esophagus. There are no drugs that can clearly reverse Barrett’s esophagus; endoscopic treatment usually removes the lesions and is performed under conventional gastroscopy or painless gastroscopy with less pain and faster recovery, but it cannot prevent recurrence, and gastroesophageal reflux still needs to be controlled after treatment. Surgical treatment problems: if symptoms or esophagitis do not resolve after regular medical treatment, or if they are prone to recurrence, anti-reflux surgery – fundoplication – is feasible, which can be done by dissection or laparoscopy; Barrett’s esophagus with severe complications should be subjected to lesion esophagectomy.