Esophageal carcinoma is one of the most common malignant tumor, a serious threat to human health. In the early and middle esophageal carcinoma patients, surgery is the only expected treatment to cure esophageal carcinoma. Traditional surgery of esophageal cancer needs thoracotomy and laparotomy, which has great trauma and high incidence of complications. So surgeons are looking for a minimally invasive surgical methods alternative to traditional esophagectomy. Video-mediastinoscopy is used to free middle and upper esophagus, as a minimally invasive surgical method, it is used in radical resection of esophageal cancer gradually. This article reviews the recent progress and the related research results in the application of mediastinoscopy in the radical resection of esophageal cancer. It is found that mediastinoscopy assisted the radical resection of esophageal cancer is a safe and feasible operation. It provides a feasible treatment option for early and middle stage esophageal cancer patients with pulmonary insufficiency who can not be resected by thoracoscopy.