The management of malignant and esophageal strictures with radiation and chemotherapy is reviewed. There is no evidence to support the use of adjuvant radiation. Studies demonstrate that concurrent chemotherapy and radiation are superior to radiation alone. The trials of preoperative combined chemotherapy and radiation are discussed, and it is suggested that further studies are needed before such treatment could be accepted as standard therapy. The roles of radiation and chemotherapy in palliative management are briefly discussed, and some potential areas for further study are proposed.