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Endoscopic submucosal dissection (ESD) is a minimally invasive technique developed by Japanese endoscopists that allows one-piece endoscopic removal of early malignant lesions in the gastrointestinal tract. There is now a large and ever-increasing number of reports worldwide, and in the West use of this technique is on the increase. New materials and techniques have been developed to improve the technical aspects of ESD. Recent reports show successful clinical outcomes and improved overall 5-year survival rates for this technique. This review aims to offer an update of ESD based on the latest reports in the literature.