To investigate the diagnostic value of narrow-band imaging (NBI) endoscopy for esophageal polyps in children. Microscopic morphology of various polyps in 35 children with esophageal polyps in Children""s Hospital of Shanghai from January 2016 to June 2020 were observed under both traditional white light endoscopy and NBI endoscopy. The sensitivity and specificity of traditional white light endoscopy and NBI endoscopy were compared with the pathological results as the gold standard. A total of 70 esophageal polypoid lesions were found in 35 children, including 27 single polyps. Pathological results indicated that the majority of polyps were non-neoplastic polyps (52.9%, 37/70).The sensitivity of NBI endoscopy in the diagnosis of esophageal neoplastic polyps was significantly higher than that of white light endoscopy [93.9% (31/33) VS 90.9% (30/33), P < 0.001], and the specificity was also higher [89.2% (33/37) VS 78.4% (29/37), P=0.864]. By observing the microscopic structure of esophageal polyps, NBI endoscopy contributes to the clinical prediction of the pathological properties of polyps. Its sensitivity is superior to the white light endoscopy.