23 Background: The endoscopic ultrasonography (EUS) is positioned as the method of choice to evaluate the origin and depth of invasion for the esophageal mass. To overcome the disadvantages as aspiration resulting from water filling EUS and balloon rupture resulting from balloon EUS, we used condom method EUS for esophageal mass evaluation. Methods: We investigated retrospectively twenty six patients examined condom method EUS using high frequency ultrasound probes after diagnosed esophageal mass lesion including submucosal tumor by standard endoscopy between January 2007 and April 2015 at Seoul Paik Hospital, Seoul, Korea. We checked the originating layer, invasion depth and echogenicity of the mass and events complicated by procedure. Results: The condom method EUS provided high quality images without aeration and well-defined five layers of esophagus through 360 degrees. In all segments of esophagus; upper (n = 5), middle (n = 10), lower esophagus(n = 11), showed high resolution images without difference. Diagnosis were squamous cell cancer (n = 4), leiomyoma (n = 5), squamous intraepithelial neoplasia (n = 2), acanthosis (n = 2), inflammatory fibrinoid polyp (n = 1) and extrinsic compression (n = 1). Tumors were originated from mucosa (n = 5), muscularis mucosa (n = 10), submucosa (n = 3), mucosa invading into submucosa (n = 4), muscle propria (n = 3). One was diagnosed as outer compression. In esophageal cancer patients, by confirming the location and invasion of the tumor, we could make a decision the next step such as follow up, endoscopic removal or surgery. No complications had occurred in all cases, aspiration or balloon rupture. Conclusions: The condom method EUS is already known as a safe image diagnostic tool of high resolution. Simply to apply inexpensive latex condom filled with water can provide good EUS visual field and images of the esophageal mass lesions along the whole esophagus without aspiration risk.