In general, the cancer rate of Barrett’s esophagus is less than 1%, and most patients do not develop cancer, and the time required for cancer to occur varies widely, and may be years or decades. Barrett’s esophagus usually appears in patients with gastroesophageal reflux, where the squamous epithelium of the normal esophageal mucosa can be replaced by columnar epithelium, often accompanied by intestinal epithelial metaplasia, when stimulated by gastric acid and other substances in the stomach. Intestinal epithelial metaplasia with atypical hyperplasia carries the risk of concomitant neoplasia, but its risk is generally low. Gastroscopy is usually repeated regularly on top of drug therapy. For patients without atypical hyperplasia, gastroscopy should be repeated 1-2 years; for mild atypical hyperplasia, it is recommended to review at least once a year; for severe atypical hyperplasia, it may be necessary to review once every 6 months, and endoscopic mucosal debridement, laser, electrocoagulation, or even surgical treatment may be considered. Patients with Barrett’s esophagus should not worry too much. With regular review, regular application of medication, improvement of lifestyle and early detection and treatment, most patients will not develop cancer.