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Some special features of the surgical anatomy of the esophagus should be summarized: (1) the major organs surround the esophagus, (2) the esophagus passes through the neck, chest and abdomen, (3) the esophagus is limited by sphincters, (4) the lymphatic distribution is abundant, and (5) the organs and structures of the mediastinum may often show anatomical variations. Unfortunately, the classical anatomical description of some organs and structures differs from the clinical presentation. Anatomists frequently portrait the esophagus in didactic books in a stylized fashion commonly not useful for surgeons. In addition, minimally invasive surgery also brought a restricted but magnified view of the esophagus, and available imaging technology forces the understanding of sectional and regional anatomy. Sir William Halsted, father of the surgical residence training among other remarkable achievements, may be quoted regarding the view provided by dissecting a patient during surgery: there is a gap between the surgeon and the pathologist that only the surgeon can bridge. The pathologist rarely has the opportunity to see pathological conditions as the surgeon sees them. Furthermore, there is no standardization of classification and nomenclature of some structures in and around the esophagus.