Endoscopic mucosal resection has become the standard of care for early gastrointestinal cancer. The application of this new treatment requires an accurate stadiation of the neoplasia. The exclusion of nodal involvement and the evaluation of the depth of tumor penetration within the gastrointestinal wall is essential to select patients who can benefit from this approach. Echoendoscopy allows endoscopists to evaluate subtle changes in the layers of the gastrointestinal wall giving an important aid to local tumor staging and planning the adequate treatment.