Aims: The definition of Barrett's esophagus is based on the presence of specialized intestinal metaplasia (SIM), however, other types of glandular mucosa may also be present in the same sample, which are usually neglected. Therefore the aim was to obtain data about the frequency and features of other types of metaplasia coexisting with SIM in routine esophageal biopsy samples. Materials and methods: In 2006, 107 SIM cases were diagnosed. Specimens were re-evaluated by classical histochemistry using HE, Giemsa and PAS – Alcian Blue (pH=2.5) stainings. Results: Only 19 cases contained pure SIM. In 34 cases cardiac, in 28 cases both cardiac and oxyntic mucosa were also identified adjacent to SIM, respectively. In the rest of the cases (n=28) cardiac mucosa, oxyntic mucosa, pancreatic acinar cell metaplasia, stratified ciliated epithelium and Schaffer's glands were shown in combination with SIM. Conclusion: It is essential to take multiple samples because in more than 80% of samples SIM exhibited islands adjacent to other types of metaplasias. Presence of cardiac mucosa and stratified – ciliated epithelium close to SIM raises the possibility of intestinal transdifferentiation through pseudogoblet cells. The obtained data confirm the view that cardiac mucosa, which containins pseudogoblet cells, especially with stratified epithelium predicts SIM.