Barrett’s esophagus is a pathological phenomenon in which the compound squamous epithelium of the lower esophagus is replaced by a single layer of columnar epithelium with or without intestinalization. It is a precancerous lesion of esophageal adenocarcinoma with intestinal epithelial metaplasia. Barrett’s esophagus mainly presents with symptoms of GERD, such as heartburn, acid reflux, retrosternal pain and dysphagia, and is often secondary to GERD. It is currently believed that the main clinical significance of Barrett’s esophagus is its association with esophageal adenocarcinoma, and routine screening is not recommended for the general population and patients with GERD alone? However, screening should be performed in those patients with multiple other risk factors, such as age 50 years or older, chronic reflux esophageal disease, diaphragmatic hernia, and obesity, especially abdominal obesity. The diagnosis of this disease is based mainly on endoscopy and esophageal mucosal biopsy. The diagnosis is made when the presence of columnar cells is confirmed by pathological examination, and is further supported by the presence of intestinal epithelial metaplasia. The principles of treatment for this disease are to control GERD, eliminate symptoms, and prevent and treat complications, including heterogeneous hyperplasia and carcinoma. Specific treatment includes: 1. Pharmacological treatment: Acid suppressants are the main drugs used to treat reflux symptoms. 2.Endoscopic treatment: for BE patients with severe heterogeneous hyperplasia and cancer confined to the mucosal layer. 3.Surgical treatment: For BE patients with confirmed cancer, in principle, they should be treated surgically. 4.Anti-reflux surgery: including surgical and endoscopic anti-reflux surgery. Given that Barrett’s esophagus has the risk of developing into esophageal adenocarcinoma, patients should be followed up regularly for early detection of heterogeneous hyperplasia and carcinoma. The interval of endoscopy should depend on the degree of heterogeneous hyperplasia. If no heterogeneous hyperplasia or early cancer is detected after 2 examinations, the interval between examinations can be relaxed to 3 years. For those with mild heterogeneous hyperplasia, endoscopic review should be conducted once every 6 months in the first year, and if the heterogeneous hyperplasia does not progress, the review can be conducted once a year. For BE with severe heterogeneous hyperplasia, there are two options: endoscopic or surgical treatment is recommended, or close monitoring and follow-up with gastroscopy every 3 months until the detection of intramucosal cancer. Therefore, Barrett’s esophagus itself is of limited danger and the clinical symptoms are not serious, but it should still be taken seriously because of the possibility of cancer.