Background: Transnasal esophagoscopy (TNE), a new diagnostic technology, allows comprehensive, in-office examination of the esophagus without sedation. Objective: To report the authors' experience using TNE. Methodology: Retrospective review of 100 consecutive patients undergoing TNE. Results: The most frequent indications for TNE were screening examination of the esophagus in reflux, globus, and/or dysphagia patients (n = 79), biopsy of a lesion in the laryngopharynx, trachea, or esophagus (n = 8), screening examination of the esophagus in head and neck cancer patients (n = 5), tracheoscopy and bronchoscopy (n = 4), and evaluation for an esophageal foreign body (n = 2). Four procedures were aborted secondary to a tight nasal vault. Significant findings were found in 44% (42/96). The most frequent findings were esophagitis (n = 19), Barrett's (n = 6), hiatal hernia (n = 4), and carcinoma (n = 5). Conclusions: TNE is safe and well tolerated by patients with topical anesthesia alone. TNE may replace radiographic imaging of the esophagus in otolaryngology patients with reflux, globus, and dysphagia. (Otolaryngol Head Neck Surg 2001;125:588-9.)