Benign esophageal tumors are rare, accounting for about 0.5-0.8% of all esophageal tumors. Because of mild or asymptomatic symptoms, patients often do not seek medical advice or are ignored by clinicians. In recent years, due to the advancement of X-ray and other examination techniques, the number of detected cases has gradually increased, 90% of which are esophageal smooth muscle tumors. Esophageal smooth muscle tumors originate from the intrinsic muscular layer of the esophagus, mainly from the longitudinal muscles, and most of them are in the wall of the esophagus, while some of them protrude into the lumen in the shape of polyps. Tumors can occur in any part of the esophagus, but in China, the middle part is the most common, the lower part is the second most common, and the upper part is the least common. Most of the tumors are solitary. The size of tumor varies, with 2-5 cm being the most common. The tumors are round or oval in shape, but there are also irregular shapes, such as lobulated, spiral, ginger-shaped, and horseshoe-shaped around the esophagus. The malignant transformation of esophageal smooth muscle tumor into sarcoma is rare, with some literature reporting 10.8%. Now with the development of ultrasound endoscopy, many of the originally thought smooth muscle tumors are mesenchymal tumors, which are hypodense endoscopically. Treatment Surgical treatment: Although smooth muscle tumors are benign diseases, they have the potential to become malignant. Generally, they grow slowly, but the lesions keep progressing and can compress the surrounding tissues to produce a series of complications when they are larger. Therefore, except for those who are older, have small tumors, have no obvious symptoms, have poor cardiopulmonary function and cannot tolerate surgery or patients refuse surgery, they can be followed up and observed, otherwise, once the diagnosis is clear, surgery is advocated. Television thoracoscopic myomectomy can be the treatment of choice for smooth muscle tumors in the intrinsic muscular layer of the esophagus, and endoscopic resection can be considered for smooth muscle tumors in the mucosal muscular layer of the esophagus. Recently, we performed a full thoracoscopic resection of a large esophageal smooth muscle tumor with a horseshoe-shaped body that was nearly in a complete circle. CT imaging of the specimen is relatively rare.