The risk of esophageal adenocarcinoma increases with higher grades of dysplasia specifically high-grade intraepithelial neoplasia (HGIN) that warrants endoscopic treatment. Endoscopic treatment techniques include photodynamic therapy (PDT), radiofrequency ablation (RFA), cryoablation, argon plasma coagulation (APC), multipolar electrocoagulation (MPEC), endoscopic resection (ER), and endoscopic submucosal dissection (ESD). The choice of endoscopic treatment technique depends upon the stage and extent of Barrett’s neoplasia, the presence of visible lesion, and the availability of expertise and equipment. These modalities are safe and very effective in maintaining complete remission comparable to surgery. In this chapter, we will discuss the different endoscopic treatment strategies for Barrett’s neoplasia in detail.