Pedicled jejunal flap and colon transplantation are two commonly used surgical procedures for esophageal reconstruction in esophageal cancer patients with a history of gastrectomy or esophagogastrectomy. Although the choice proportions of the two approaches are equivalent, the proportion of using pedicled jejunal flap has been gradually increased. The incidences of graft loss and anastomotic leakage are similar between the two procedures, but the mortality rate after colon transplantation seems to be higher than that after jejunal flap transplantation. Therefore, the optimal method for reconstruction is still controversial at present. The authors address the issues of these concerns.