Background. Treatment of pT1 esophageal cancer is increasingly performed by endoscopic local therapy. The aim of our study was to analyze the distribution of lymph node metastases in esophageal resectates of mucosal- (pT1a) and submucosal esophageal cancer (pT1b, sm level I-III) with a differentiated view of the two predominant histologic tumor types.Methods. Out of 507 patients who underwent esophageal resection due to malignancy between 9/1985 and 8/2007 in our department, in 62 patients a pT1-squamous cell carcinoma or adenocarcinoma was found. In 45 of these, paraffine-embedded blocks were worked up by a single pathologist (T.H.) with respect to the differentiation between mucosal and submucosal (sm) carcinomas and - in the latter - the tumor depth according to the level sm I-III classification. All patients had a complete follow-up. Results. Lymph node metastases were found in 14.3% of pT1a squamous cell cancers and in 10% of pT1a adenocarcinomas. pT1b sm level I-II tumors revealed a positive lymph node rate in 16.7% (squamous cell cancer) and in 28.6% (adenocarcinoma) respectively. Sm level III-squamous cell carcinomas had in 20% and adenocarcinomas in 25% a pN1-category. Long-term survival was not statistically significant different between pT1a, sm I-II und sm III-esophageal cancers with respect to both histologic tumor types (log rank-test: p=0.6578 (squamous cell carcinoma) and p=2.162 (adenocarcinoma) respectively). Conclusion. pT1 esophageal cancer reveals a high prevalence of lymph node metastases. Curative treatment in these patients can only be achieved by surgical resection and radical lymph node dissection. Local-therapeutic procedures in esophageal cancer requisite a perfect pretherapeutic staging with detection of all potential lymph node metastases.