AIM: To study the different causes of esophageal dysphagia in cases presenting to the GI Endoscopy Unit of Kasr EL-Aini Hospital and to state lines of their endoscopic management.METHODS: This is a retrospective analysis of prospectively collected data over 5 years. Data was analyzed to study the different causes of esophageal dysphagia in cases presenting to the Gastrointestinal Endoscopy Unit- Kasr EL-Aini hospital through the period from May 2005 till May 2010.RESULTS: Total number of index upper endoscopies was 23,363 patients. 895 (3. 83 %) patients presented with dysphagia, they were 498 (55.63%) males and 397 (44.43%) females, with male: female ratio of 1.25:1. Their age ranged from 2 to 91 years old with mean age of 45.598 ±19.792 years. Patients were divided according to endoscopic findings into structural disorders (433 cases; 48.38%) that included cancer esophagus (184 cases; 20.56%) and post-corrosive stricture (143 cases; 15.98%), esophagitis (203 cases; 22.68%), Motility disorders (140 cases; 15.64%), foreign body (106 cases; 11.84%) and extrinsic compression (13 cases; 1.45%).CONCLUSION: Esophageal carcinoma is the most common cause of dysphagia & upper gastrointestinal endoscopy is most important in identification & management of various causes of dysphagia.