An observational study was conducted on 200 patients who presented complaints of dysphagia, both in the surgical outpatient department (OPD) and those admitted for further management in the ward. A comprehensive assessment, including detailed history, clinical examination, and endoscopy, was carried out. Given the assumption that dysphagia could be indicative of malignancy unless proven otherwise, each patient underwent evaluation. Diagnoses were established through a combination of clinical assessment, endoscopic findings, and histopathological results, guiding subsequent management decisions, which included conservative, palliative, endoscopic, and various surgical approaches such as open, laparoscopic, and minimally invasive techniques.The study revealed several key findings. Among the 200 patients, 70% were smokers, 26% were alcoholics, and 17% were tobacco chewers. The incidences of upper, middle, and lower esophageal malignancies were 7%, 7%, and 1%, respectively. Ca esophagus was present in 14% of the cases, while 43% had inflammatory pathologies like esophagitis, duodenitis, and gastritis. Barrett's esophagus was observed in 4% of patients, and 12% experienced dysphagia without any pathological findings. Endoscopy yielded no findings in 4% of cases, while 11% had conditions such as hiatus hernia, lipoma, diverticulum, and esophageal varices. Additionally, 12% suffered from extraluminal compression from external sources.Treatment varied based on the diagnosis, with 65% undergoing conservative measures, 7% requiring exploratory laparotomy and abdominal surgery, 14% undergoing esophageal surgery (including Ivor Lewis and transhiatal esophagectomy), and 7% receiving endoscopic and palliative interventions for malignancies.The study's results strongly suggest a correlation between dysphagia and habits like tobacco chewing, alcohol consumption, and smoking. Early diagnosis of the disease, identification of premalignant lesions, and appropriate management interventions can play a crucial role in preventing esophageal cancer.