Twelve consecutive operations for the treatment of constricting esophageal lesions by interposing a segment of colon are reviewed. There were three types of constrictions: lye strictures, peptic strictures, and carcinoma. The last-named comprised one half of the total. If the operation is done by two teams and the patient is well prepared, operative mortality will be low, although most patients are elderly. The preferred operation bypasses the thoracic esophagus by placing the esophagocolonic-anastomosis in the neck. A breakdown of the anastomosis in the neck will result in very little morbidity and almost no mortality as compared with breakdowns in the thorax. Thus the program outlined by the authors for the treatment of carcinoma of the esophagus, when feasible, is (1) colon interposition, (2) supervoltage radiation to the primary tumor and mediastinum, and (3) radical esophagectomy.