Objective To improve diagnosis on esophageal tuberculosis by the endoscopic ultrasonography (EUS).Methods A retrospective analysis of 9 cases of esophageal tuberculosis patients diagnosed by EUS or EUS guided ifne needle aspiration (EUS-FNA) who were treated from 2011 to 2016 and literature reviewed.Results The main presenting symptoms were dysphagia (6 cases), burning pain after sternum (3 cases), low-grade fever and night sweat (2 cases), cough and hemoptysis (1 case). The middle esophagus was involved in 7 cases, upper and lower third of the esophagus were affected in 1 cases. The endoscopic appearances included ulcer (1 case), mass lesion (8 cases). The diagnoses were conifrmed by biopsies with pathology in 5 cases. The layers of the esophageal wall were unclear or disappeared in some cases, and in some patients low echo occupying lesions inside or outside the esophageal wall were showed by EUS. The internal echo of the lesions was heterogeneous, and strong echo spots could be observed. In most cases, enlarged mediastinal lymph nodes were observed. EUS-FNA was used to take biopsy specimens in 2 cases: biopsy specimens suggested tuberculosis; and anti-TB treatment has good effect as well.Conclusion Dysphagia is the major clinical symptom of esophageal tuberculosis, always inlfuences the middle part of the esophagus. The commonest abnormalities identiifed by endoscopy are ulceration and mass lesion. The diagnostic rate of the disease can be improved by endoscopic examination with biopsies, EUS and EUSFNA data.