The aim of this review is to give an overview of palliative endoscopic treatment options in patients with advanced cancers of the esophagus, stomach, pancreas and bile ducts. With regard to esophageal cancers, we will also speak about curative endoscopic treatment (photodynamic therapy, mucosectomy) of early cancers and dysplasias. We will not approach to this subject in other types of carcinoma, since this has already been covered by the acquisitions of the last years.