Dysphagia is a common symptom affecting many patients with several different causes. The use of thin, distal-chip, video esophagoscopes allows for a thorough evaluation and management of dysphagia in the office. Esophagitis should be recognized on endoscopy in addition to webs, rings, and strictures. Procedures to treat the cause of dysphagia can be performed in clinic with the use of topical anesthesia. Descriptions of how to perform procedures for dysphagia, including vocal fold medialization, diagnostic esophagoscopy, and esophageal procedures for intervention are reviewed.