Endoscopic submucosal dissection (ESD) is now widely accepted as a minimally invasive treatment for early gastrointestinal tumors. With particularity of the procedures in upper gastrointestinal track, perioperative management is one of challenges for anesthesiologists. Recent studies about the sedation/anesthesia and management in upper gastrointestinal ESD were summarized. To provide theoretical foundation of clinical practice for anesthesiologists, this review expounds the preoperative preparation and assessment, choice of anesthetics and approach for sedation/anesthesia, management of sedation and anesthesia，as well as treatment of frequently observed adverse events.