Objective To investigate the safety and efficacy of overthescope clip(OTSC) in the endoscopic treatment for anastomotic leakage after esophagectomy of esophageal cancer. Methods Preoperative clinical data

intraoperative conditions and postoperative effect of 11 patients with anastomotic leakage after esophagectomy of esophageal cancer and treated by OTSC from January 2016 to June 2018 in second affiliated hospital of army medical university were analyzed retrospectively. Technical success was defined as OTSC can be fully expanded on the target lesion and successfully closure of the anastomotic leakage during the operation，clinical success was defined as sustained closure of the anastomotic leakage without surgical or other endoscopic treatment after a minimum follow up of 2 months. Results The average diameter of the anastomotic leakage was （7.09±2.84）mm，the median time between diagnosis and OTSC application was 21 days（17 to 55 days）. The technical success rate was 90.9%(10/11)，the average time from the successful installation of OTSC in vitro to successful release was （7.10±2.13）minutes，the clinical success rate was 50%（5/10）. No complication related to endoscopic operation was observed in all the patients either during or after the endoscopic operation. Conclusion OTSC is suitable for patients with leakage less than 10 mm without anastomotic stenosis after esophagectomy of esophageal cancer. But its longterm effect needs to be evaluated by more clinical studies. The duration of anastomotic leakage may be a factor affecting its longterm effect.