Background: According to Globocan 2018 estimate esophageal cancer ranks the eighth and ninthrnas the leading cause of cancer mortality and morbidity respectively in Ethiopia. Althoughrnesophageal lesions particularly cancer is a public health problem in Ethiopia, there are limitedrndata on the margin status, gross description of carcinoma, and proportion of nonneoplasticrndisease in the country. rnObjectives: This study aims to assess the histologic type and anatomic location of esophagealrnlesions overall, and gross description, length of the involved segment, radial margin status, andrnpathologic stage group of esophageal carcinoma at Tikur Anbessa Specialized Hospital Addis rnAbaba, Ethiopia. rnMethods: The study was carried out at Tikur Anbessa Specialized Hospital Addis Ababa, rnEthiopia. The record of 518 patients who had histopathological diagnosis of esophageal lesionsrnover a period of 4 years and 8 months between January 01, 2016, and August 30, 2020, werernretrospectively analyzed. A structured data extraction tool was used to collect importantrnvariables. Descriptive statistics such as mean, median, frequency, and percentages, etc... wererncomputed using SPSS computer software version 26.0. rnResult: Out of 518 esophageal endoscopic and resection specimens studied 294(56.8%) werernfemales and 224(43.2%) were males. An age range of 35 days up to 86 years was observed.rnThere Were 475 (91.7%) malignant Cases, 34(6.56%) nonneoplastic cases, and 9(1.73%) rnprecancerous cases. From malignant cases, 46.9% occurs in the distal third of the esophagusrnfollowed by 25.1% in the middle third. The mean and median tumor lengths were 4.23 and 4 cmrnrespectively. The most common macroscopic (gross) finding was diffusely infiltrative orrnconstricting 46(48.4%) followed by Fungating or ulcerative38(40.0%). There were 374(78.7%)rnsquamous cell carcinoma and its variants, 94(19.8%) adenocarcinoma and its variants, 6(1.3%)rnadenosquamous cell carcinoma, and 1(0.2%) undifferentiated carcinoma. 42(44.7%) had positivernradial margin status. The commonest histologic grade is G1 29 (48.3%) followed by G3 17rn(28.3%) and G2 14 (23.3%). The most common pathologic stage group was stage III 49(54.5%) rnfollowed by stage II 27(30%), and stage I and IV each account for 7(7.8%). rnHalf of premalignant cases occur in the middle third and the other half in the distal third. The rnmost common histologic type was high-grade squamous dysplasia 5(55.6%) followed byrnBarrett's esophagus with low-grade dysplasia 2(22.2%). 56.3% nonneoplastic cases occur in therndistal third followed by two or more segments in 21.9%. Barrettes esophagus, Nonspecific rnesophagitis, and benign ulcers account for more than 60 % of the casesrnConclusion: The majority of esophageal lesions were malignant and are squamous cell rncarcinoma. Overall cancer of the esophagus mainly affects the distal 1/3 of the esophagusrnincluding GEJ. Most carcinomas are well-differentiated, in pathologic stage III, and havernpositive radial margin status.