Objective To compare the efficacy of endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)on early esophageal cancer and precancerous lesions whose diameter between 2 cm and 3 cm.Methods The clinical data of 77 patients with early esophageal cancer and precancerous lesions who had accepted endoscopic treatment were retrospectively analyzed.The diameter of lesions in both groups were between 2 cm and 3 cm.There were 37 patients with 42 lesions accepted EMR (EMR group),40 patients with 41 lesions accepted ESD(ESD group).The effectiveness of two endoscopic treatment methods was analyzed,by observing the bleeding,perforation,the incidence of postoperative esophageal stenosis and recurrence.Results The bleeding,perforation rates were 7.1％ (3/42),0 respectively in EMR group,which were lower than those in ESD group [24.4％(10/41),17.1％(7/41)],and the differences were statistically significant(P ＜ 0.05 or ＜ 0.01).The incidence of esophageal stenosis between two groups showed no significant difference(P ＞ 0.05).The recurrence rate in EMR group was 14.3％(6/42),which was significantly higher than that in ESD group(0),and the difference between two groups was statistically significant(P＜ 0.05).Conclusions The effect of ESD for treating early esophageal cancer and precancerous lesions whose diameter between 2 cm and 3 cm is much better than EMR.But ESD has the risk of bleeding and perforation.Both of them in the postoperative esophageal stenosis have no significant difference.