Barrett esophagus is the term describing the presence of an abnormal columnar epithelium in a portion of the esophagus. We have treated 19 patients within the past three years, representing almost 20% of all our esophageal experience; This one pathologic entity has presented as several different clinical pictures: benign stricture, peptic ulceration of the esophagus, intractable esophagitis, and malignancy. One half the patients were under 50 years old, and most were male. The benign lesions have responded well to surgical therapy. There has been an unusually high incidence of malignancy-26.3%. The reasons for the infrequent diagnosis of Barrett esophagus are confusion with "short esophagus" and failure to biopsy the proper site.