The incidence of oesophageal cancer continues to increase worldwide, particularly adenocarcinoma of the distal oesophagus and gastro-oesophageal junction. Unfortunately, overall survival rates remain disappointingly low, even in those patients who are fit for radical (curative) treatment at presentation. Surgery, with or without preoperative chemotherapy, remains the treatment of choice in the UK for those patients of adequate performance status who have potentially resectable disease. An alternative approach is chemoradiotherapy, which is associated with similar long-term survival rates, at least in patients with squamous cell carcinoma. The survival of patients with advanced disease may be prolonged by palliative chemotherapy, and there are a number of treatment modalities that may be used to relieve dysphagia; their use often reflects local availability and expertise. This review summarises the recent trends in the incidence and aetiology of oesophageal cancer and provides an up-to-date overview of its management.