Fifty-two patients with proven esophageal malignancy underwent esophagography, computed tomography (CT). esophagoscopy, and/or surgical exploration and resection. On the basis of CT findings, esophageal carcinoma was classified into four stages: stage I, intraluminal mass without esophageal wall thickening; stage II, esophageal wall thickening (greater than 5 mm); stage III, esophageal wall thickening and contiguous spread of tumor into adjacent mediastinal structures such as the trachea, bronchi, aorta, or atrium; and stage IV, any stage with evidence of distant metastatic disease. The stage of esophageal malignancy as determined by CT was correlated with symptoms, location of tumor, esophagography, and surgical findings. Results indicated that CT staging of esophageal carcinoma correlated closely with surgical findings and that local extension, regional adenopathy, and size of tumor mass were better evaluated by computed tomography than by other methods. CT is an accurate method of preoperatively staging esophageal carcinoma, capable of providing staging information heretofore only available by surgical exploration.