Objective To evaluate the lfexible spectral imaging color enhancement (FICE) system associated with mini-probe endoscopic ultrasonography in diagnosis of superifcial esophageal lesions.Methods 292 patients with superficial esophageal lesions were randomly assigned to control group or observation group. The common white light endoscopy and magnifying endoscopy were used in the control group while FICE associated with mini-probe endoscopic ultrasonography in the observation group. Findings were compared with the pathologic diagnosis.Result The magnifying FICE could reveal the IPCL of superifcial esophageal lesions and can accurately determine the pathological types of lesions. The diagnose accordance rate of esophagitis by magnifying FICE was 82.69%, mild and moderate atypical hyperplasia highly atypical hyperplasia 86.96%. The diagnostic accuracy rate of esophagus lesions between observation group and control group was 91.78 %, 76.02 % respectively. And the diagnostic sensitive rate between two groups was 85.71%, 44.44%. The former is superior to the latter. There were 5 lfat lesions found by FICE which were missed diagnosed by white light endoscopy.Conclusion FICE can enhance the ability of identiifcation of lesion which shows the outline and morphology of lesion and can improve the biopsy accuracy. FICE associated with mini-probe endoscopic ultrasonography has a certain clinical application value in the diagnosis and treatment of superifcial esophageal lesions.