Objective: To assess the clinical value of endoscopic submucosal dissection (ESD) for sessile colorectal lesions. Methods: The clinical data of 17 patients with large sessile colorectal lesion that was detected by enteroscopy and underwent ESD were retrospectively analyzed. Results: ESD was successfully performed in all the 17 patients. The average operative time was (68±21) min, and average diameter of the lesions was (3.0±1.5) cm. Intraoperative bleeding occurred in 4 patients and postoperative delayed bleeding occurred in 3 patients, which were all resolved by using hot biopsy forceps, APC or titanium clip under enteroscope. Bowel perforation occurred during operation in 2 patients, which in one case was sutured with titanium clip under enteroscope and the other case was treated by open bowel repair. The postoperative pathology study verified that 3 cases were tubular adenoma, 4 were villous adenoma, 2 were low-grade intraepithelial neoplasia, 3 were high-grade intraepithelial neoplasia, 2 were hyperplastic polyps, 1 was carcinoid 1, and 2 were early cancer (T1N0M0). All patients were cured and discharged from hospital, and no recurrence was noted during follow-up for 2–27 months. Conclusion: ESD is a safe and feasible procedure for sessile colorectal lesions; it has the advantages of minor trauma, quick recovery and no abdominal scar and its use is recommended.