Surgery for severe heterogeneous hyperplasia of the esophagus is better, and radical esophagectomy for esophageal cancer has been developed and mature nowadays, which can remove the diseased esophagus. Severe heterogeneous hyperplasia of esophagus is a kind of precancerous lesion of esophagus, which is due to abnormal differentiation of esophageal mucosal epithelium and glands after long-term stimulation of esophagitis and esophageal ulcer. Clinical manifestations include acid reflux, heartburn, retrosternal pain and discomfort, and decreased appetite. At present, severe heterotrophic hyperplasia of the esophagus can be treated with endoscopic minimally invasive surgery or surgical radical surgery. Minimally invasive endoscopic surgery refers to esophageal mucosal dissection under gastroscope to peel off the diseased mucosal tissues, which is less traumatic but has a higher recurrence rate. Surgical radical surgery is direct resection of the diseased esophagus, with fewer postoperative sequelae and lower recurrence rate but higher surgical trauma. Severe heterotrophic hyperplasia of the esophagus is generally amenable to surgery, and the survival rate after surgery is higher than that of conservative treatment, regardless of the surgical approach. Currently, the surgical method is mature, if the pathology report is severe heterotrophic hyperplasia of the esophagus, the relevant surgery should be performed at an early stage to avoid cancerous transformation.