Esophageal carcinoma continues to have a poor prognosis with limited treatment options. Potential surgical curative treatment exists only for early stage cancers, with palliative treatment used for the most advanced cancers. Photodynamic therapy (PDT) is a treatment modality for both early and advanced cancers of the esophagus that has shown encouraging results. This article reviews the background, biology, and mechanism of photodynamic therapy in cancer treatment. In particular, the indiciations and contraindications to PDT with regard to esophageal carcinoma are discussed, as well as the need for proper patient selection and pretreatment evaluation. Specific detail will be provided in discussing the technique of administering photodynamic therapy for the treatment of esophageal cancers. The administration of the light photosensitizer, selection of the appropriate light dosimetry, proper endoscopic delivery of the light treatment, and recommended follow-up for both early and late stage cancers after completion of PDT are discussed. Finally, complications that can occur with the use of this relatively new treatment and how to avoid and manage these complications are reviewed.