Submucosal elevations in the esophagus are not necessarily malignant and do not exist 99% of the time; they can also be venous tumors, benign tumors, and other conditions. A mucosal elevated lesion found in the esophagus is not always cancer. Benign lesions such as papillomas or isolated venous tumors can also present as elevated esophageal mucosa. In addition, benign lesions such as esophageal smooth muscle tumors or granular cell tumors, which originate in the submucosal layer of the esophagus, may also present endoscopically as smooth-surfaced elevated changes. The origin and nature of an elevated lesion should be determined by the morphology, color, and microvascular changes of the mucosal surface of the lesion. This can be combined with electron pigmented endoscopy, such as narrow-band imaging or spraying with Lugol’s iodine, to determine the nature of the lesion as well as its benign or malignant nature. For elevated lesions of suspected submucosal origin, ultrasonographic endoscopy can be performed to determine the level of origin of the lesion, and the echogenicity of the lesion can be used to make a preliminary determination of the lesion’s nature. A biopsy of the elevated area can also be performed to clarify the diagnosis. It is recommended that the patient follow the doctor’s instructions to further improve the relevant examinations to determine the cause of the disease, and after diagnosis and active treatment, so as to avoid delays in the condition.