Oesophageal cancer is primarily categorized into two types: Squamous Cell Carcinoma (SCC) and Adenocarcinoma (ACA). SCC affects the middle third of the oesophagus and is linked to smoking, alcohol consumption, and low socio-economic status. ACA affects the lower third and is associated with gastro-oesophageal reflux disease (GORD). The UK has the highest incidence of ACA globally, which is rising. Treatment options include palliative and curative approaches. Curative treatment involves neo-adjuvant chemotherapy or chemoradiotherapy followed by surgery, with the most common operation being a two-phase Ivor-Lewis oesophagectomy. Minimally invasive surgery is increasingly used. Modern management has reduced perioperative morbidity and mortality, but long-term survival improvements have been slow. Enhanced patient pathways and stratified therapies based on molecular characteristics offer potential for further advancements. Ongoing clinical trials are evaluating the role of monoclonal antibodies in treating oesophageal cancer.Oesophageal cancer is primarily categorized into two types: Squamous Cell Carcinoma (SCC) and Adenocarcinoma (ACA). SCC affects the middle third of the oesophagus and is linked to smoking, alcohol consumption, and low socio-economic status. ACA affects the lower third and is associated with gastro-oesophageal reflux disease (GORD). The UK has the highest incidence of ACA globally, which is rising. Treatment options include palliative and curative approaches. Curative treatment involves neo-adjuvant chemotherapy or chemoradiotherapy followed by surgery, with the most common operation being a two-phase Ivor-Lewis oesophagectomy. Minimally invasive surgery is increasingly used. Modern management has reduced perioperative morbidity and mortality, but long-term survival improvements have been slow. Enhanced patient pathways and stratified therapies based on molecular characteristics offer potential for further advancements. Ongoing clinical trials are evaluating the role of monoclonal antibodies in treating oesophageal cancer.