Introduction: This video shows the submucosal tunneling endoscopic resection (STER). Today, endoscopic submucosal dissection (ESD) is increasingly used for superficial esophageal cancers and esophageal submucosal tumors (SMTs),1,2 but the surgical area in the esophagus is limited and the esophageal adventitia is very thin. As improved ESD technology, STER can reduce risk of postoperative gastrointestinal (GI) tract leakage and secondary infection.3 Method: This was a 56-year-old patient who found it difficult to swallow since November 23rd 2013. Then, she went to hospital and had a computer tomography (CT) scan and endoscopic ultrasonography; both of them showed there was an SMT in the middle segment of the esophagus. The patient had no other symptoms besides dysphagia, and the blood routine examination is regular. On December 4th 2013, we decided to use STER to treat this lesion. After a short anesthesia induction, we found there had been a lesion of about 1.5×1.5 cm with smooth surface in the middle segment of the esophagus, 21 cm far from the incisor. Then, we made the submocosal injection of diluted indigo carmine to locate the SMT. Next, a fluid cushion was obtained using an injection needle 5 cm proximal to the SMT, and a 2-cm longitudinal mucosal incision was made using the electric knife at the esophageal mucosa as the entry point. With the electric knife, a submucosal longitudinal tunnel was created between the submucosal and muscular layers. We made the tunnel end 1–2 cm distal to the tumor to ensure a satisfactory endoscopic view and enough space to work. In the tunnel, we resected the SMT under direct endoscopic visualization safely and completely. After removing the SMT, hemostatic clips were used to close the tunnel and the STER ended. Results: The pathology shows that the lesion was a spindle cell tumor and has no lymph node metastasis. The patient woke up in half an hour after STER and was discharged 3 days after the endoscopic resection. Also, she was seen 1, 2, and 4 weeks after this resection with no symptoms to report. Conclusion: To treat the SMT in the esophagus, the surgical area is limited and the esophageal adventitia is very thin for ESD. STER provides enough work space for the surgeon and reduces the infection and bleeding during the resection of the lesion. There is no conflict of interest of any kind in relation to this article between Shilun Cai, Yunshi Zhong, and Liqing Yao. Runtime of video: 8 mins 29 secs