|To identify optimal treatment, we retrospectively analyzed the clinicopathological features and clinical outcomes of 48 cases of superficial Barrett's esophageal cancer (SBEC).Pathophysiological investigation revealed 24 cases had submucosal invasion (SMI), 18 had lymphovascular involvement (LVI), 12 had poorly differentiated component (PDC), and 5 had lymphnode mtastasis (LNM). Among 33 cases that the tumor invaded shallower than 500 micrometer, 6 had LVI, 5 had PDC, and 1 had LNM. Among 15 cases that the tumor invaded into submucosa deeper than 500 micrometer, 12 had LVI, 7 had PDC, and 4 had LNM.Clinical observation revealed 18 cases were 0-Is type (elevated without narrower base). Among them, 15 had SMI, 13 had LVI, 8 had PDC, and 5 had LNM. 9 cases were 0-Ip type (elevated with narrower base). Among them, 3 had SMI, 2 had LVI, 2 had PDC, and no LNM. Median of all 48 cases' follow-up period was 105 months, 2 died in other disease and nobody died of SBEC. Selecting definitive surgery is reasonable for type 0-Is case due to its high possibility of LNM. Additional surgery is also acceptable for the cases that ER found the tumor invading into submucosa deeply. Accumulating data may provide a reasonable ground for avoiding additional surgery for the cases that the depth of tumor invasion into submucosa is 500 micrometer or more.