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Introduction: Esophageal stents (ES) may be used as an adjunct in the management of patients with resectable cancer of the esophagus (EC) to improve nutritional status during neoadjuvant therapy, or to manage postoperative anastomotic leaks or strictures. We describe our experience with the use of ES in a consecutive series of 97 patients undergoing resection of EC between September of 2007 and March of 2011. Methods: This is a retrospective record review with IRB approval. All patients receiving ES at our institution for whom follow up is available are included. The indication for ES placement was noted and the clinical effectiveness was determined: did the ES successfully resolve the clinical problem for which it was placed? Results: Among 97 consecutive patient undergoing resection of EC, 46 patients received ES for the following indications: to improve preoperative nutritional status (25 patients), for postoperative anastomotic leak (13 patients), and for postoperative anastomotic stricture (14 patients). 9 patients had multiple ES placed at different time points for multiple indications. ES deployment was technically successful in all patients. Preop ES: Swallowing symptoms improved in 52% of patients; however, nutritional status deteriorated in 80%, with a median weight loss of 15 lbs and median decrease in serum albumin of .4gms/dl. ES migration, which occurred in 64%, and upper gastrointestinal symptoms, which occurred in 72% of patients receiving neoadjuvant therapy, limited the effectiveness of preop ES. ES for postop leak: Postop leak occurred in the neck in 10 patients and in the chest in 3 patients. ES effectively sealed the leak and allowed prompt (within 48 hrs) resolution of oral intake in only 4/13 patients (31%). Early ES migration (7 patients) and the presence of limited conduit necrosis (2 patients) was associated with ES failure. ES for postop stricture: 12 of the 14 strictures for which stents were deployed were in the neck and 2 were in the thorax. 57% of patients had sustained relief of dysphagia and required a median of only one subsequent intervention for stricture. Stent failure occurred in 43%, due to early migration (4 patients), pharyngeal or mediastinal pain (1 patient each), or bilious vomiting (2 patients). ES migrated prematurely in 11/14 patients, including 6/8 successfully treated patients and 5/6 unsuccessfully treated patients. Conclusions: The effectiveness of ES placement for preop nutritional stabilization (20%) and resolution of postop leak (31%) is low. ES for postop anastomotic stricture is moderately effective (57%). The high proportion of patients with cervical anastomoses in our patient population predisposes to ES migration; in addition, the prevalence of foregut symptoms with neoadjuvant therapy limits the effectiveness of preop ES.