Abstract 【Objective】To summarize the pathologic features and endoscopic features of the early gastroesophageal junctional cancer. 【Methods】 Pathological and endoscopic features, and short-term outcomes of surgical resection were retrospectively analyzed in 401 patients who were treated with ESD at Zhongshan Hospital and Xiamen Branch of Fudan University from November 2014 to October 2021 and whose postoperative pathology was confirmed to be early gastroesophageal junctional carcinoma. 【Results】The male-to-female ratio of early gastroesophageal junctional carcinoma was 4.8:1, with Siewert II type accounting for the highest proportion, up to 70.82%. It most commonly involved the side of the lesser curvature (57.10%) and/or the posterior wall (44.63%), and was most often manifested by reddening of the mucosa (96.26%), with a mean lesion length of 2.05 cm; the morphology of the lesion was most common in type 0-IIc (38.15%). Tumor type was most common in tubular adenocarcinoma (86.53%). the ESD whole resection rate was 99.75%, and the percentage of curative resections was 72.82%. pt1b-sm2 stage contained hypofractionated or specific components in 43.55% of the cases. stenosis or hemorrhage was seen in 2.0% of the patients, which were improved with endoscopic therapy. 【Conclusion】 Early gastroesophageal junctional carcinoma occurs in middle-aged and elderly men, mostly Siewert type II, most often involving the side of lesser curvature and posterior wall, with the morphology of type 0-IIc, and the lesions under normal white light mostly show reddening of the mucosa, and the majority of them are high and middle differentiated carcinomas.ESD treatment for esophagogastric carcinoma is a safe and effective treatment method, with a high cure rate and low surgical complications. However, among the tumors resected non-curatively, tumor components containing poorly differentiated and rare types of tumor components are more likely to lead to non-curative resection.