Abstract Background Access to the cervicothoracic junction, whether by lower anterior cervical or transthoracic approach, is particularly difficult. It has been found that the cervicosternotomy allows exposure of the upper thoracic esophagus to the level of the carina. Our goal in this study is to summarize the experience in resection of the upper segment of the esophagus through cervicosternal splitting approach combined with laparoscopy and to discuss the choice of surgical approach, the clearance of lymph node and the treatment of postoperative complications. Methods From January 2016 to February 2018, 7 patients with esophageal disease underwent cervicosternotomy as part of a larger procedure. The lesion of the upper esophagus was resected by the direct anterior approach and the lower segmeat of the thoracic esophagus was freed by laparoscopic transesophageal hiatus. The stomach was taken up to the neck through the bed of esophagus and anastomoted between the stomach and esophagus. We analyzed these patients to determine the utility of this means, the ability to achieve complete resection and the outcomes. Results Of the 7 patients, 4 patients underwent radical resection for esophageal squamous cell carcinoma, 2 for esophagectomy and laryngectomy, 1 for benign stricture of the esophagus, 6 for cervical and mediastinal node dissection.The lesion of esophagus was resected in all cases. Recurrent laryngeal nerve injury in one patient with carcinoma, the only major postoperative complication in this group. There was no operative death. Conclusion The cervicosternal splitting approach can offer good exposure, high rate of resectability and low incidence of postoperative complications for the pathology of the upper segment of esophagus. Careful evaluation of the patient, focusing on the type, extent, and location of the abnormality relative to the level of the carina, often indicates that cervicosternotomy combined with laparoscopy is a safe and effective method of upper thoracic esophagectomy. Disclosure All authors have declared no conflicts of interest.