This opening session from the International Society for Diseases of the Esophagus webinar provides a global overview of lymphadenectomy practices in esophageal cancer. Dr. C.S. Pramesh outlines key differences between 2-field and 3-field lymphadenectomy, emphasizing how regional variation, tumor histology (squamous cell carcinoma vs adenocarcinoma), and evolving perioperative therapies influence surgical decision-making. The session highlights the ongoing debate regarding the extent of lymph node dissection and underscores the need for stronger long-term outcomes data to guide best practice.