Abstract： Objective To evaluate the efficacy and safety of endoscopic musoucal resection with transparent cap (EMR-Cap) and endoscopic multi-band mucosectomy (MBM) in the treatment of early esophageal cancer and precancerous lesion.Methods A retrospective study was performed to review 30 EMR-Cap cases from December 2008 to December 2009 and 32 MBM cases from January 2010 to January 2011 of early esophageal cancer and precancerous lesions.The differences between these two techniques in efficacy,safety,and cost were compared.Results In EMR-Cap group,the median resection time was 26 (10-56) min and median procedure time was 43 (22-81) min,significantly longer than those in MBM group [ 10 (7-18) min and 32 (28-45) min,P=0.036 and 0.038,respectively].There were no significant differences between the two groups in total thickness and depth of resected lesions (P＞0.05).In EMR-Cap group,the median cost was significantly higher than that of MBM group [(5466±354) vs.(4014±368) RMB,P=0.008)].Conclusions EMR-Cap and MBM are minimally invasive,safe and effective methods in the treatment of early esophageal cancer and precancerous lesions.Compared to the EMR-Cap,MBM is simple with shorter treatment time and lower cost.