Objective To evaluate the clinical value of epithelial vessel branch detected by non-magnifying narrow-band imaging (NM-NBI) in diagnosis of early esophageal cancer. Methods A retrospective analysis was performed on data of 59 patients, who underwent endoscopy with NM-NBI and iodine staining to screen early esophageal cancer in PLA General Hospital from January 2013 to May 2015. The final diagnosis for all lesions were determined by pathology. The diagnostic accuracy, sensitivity and specificity of NM-NBI and iodine staining for early esophageal cancer were compared. Results The accuracy, sensitivity and specificity of NM-NBI on the epithelial vessel branch in diagnosis of early esophageal cancer were 831% (49/59), 913% (21/23) and 778% (28/36), respectively, and the corresponding statistical values of iodine staining were 559% (33/59), 957% (22/23) and 306% (11/36), respectively. The accuracy (χ2=145, P=0028) and specificity (χ2=214, P=0000) of epithelial vessel branch by NM-NBI were significantly higher than those of iodine staining, and there was no significant difference in the sensitivity between the two methods (χ2=223, P=1000). Conclusion The observation of epithelial vessel branch using NM-NBI was useful and reliable in diagnosis of early esophageal cancer with high accuracy and specificity, and can be possible for application in the clinic.