Background: Esophageal malignancy is the fourth leading cause of cancer-related death in India. The most common malignancy of esophagus is squamous cell carcinoma (SCC) followed by adenocarcinoma. But recently, an increase in incidence of adenocarcinoma owing to lifestyle modification has been observed. Other rarer varieties such as granular cell tumor (GCT) and carcinoid tumors are also reported more frequently in the recent literatures. Review of literature: Certain types of esophageal malignancies on evaluation were characteristically localized to specific areas. For example, SCC is more common in upper and middle esophagus owing to the nature of the lining epithelium, adenocarcinoma is prevalent in lower esophagus due to Barrett's metaplasia, and neuroendocrine tumors are frequently encountered in the lower end of esophagus due to the presence of endocrine cells. But rarer types of epithelial and mesenchymal lesions cannot be localized and diagnosed based on site alone. They require histopathological evaluation for confirmatory diagnosis. In the present review, we discuss the different types of malignancies encountered in esophagus, their incidence, histopathological findings, and theranostic value. Conclusion: The incidence of esophageal malignancy has shown an upward trend in the recent years. A thorough knowledge on the varieties of lesions possible in esophagus helps in providing an accurate diagnosis, which ultimately dictates the prognosis of the patient.