Summary BACKGROUND: Carcinomas at the pharyngesophageal junction have a poor prognosis due to late symptom manifestation and diagnosis. Treatment of choice includes gastrointestinal replacement after esophagectomy. The aim of this retrospective study was to evaluate whether the type of reconstruction influences postoperative mortality, complications and functional outcome. METHODS: Out of 114 reviewed papers between 1956 and 2008, 33 papers were included in the review. Postoperative hospital mortality, non-surgical and surgical complications were assessed. Furthermore, functional success rates were compared. RESULTS: A total of 1200 patients were evaluated, out of whom 60.8% were reconstructed with gastric pull-up, 24.5% with jejunal autograft and 14.7% with colon interposition. The overall hospital mortality was 10.7%. In particular, patients with jejunal autograft presented reduced hospital mortality and fewest non-surgical complications. Lowest surgical complications and best functional success rates were reported in the gastric pull-up group. CONCLUSIONS: Cervical segmental esophagectomy with jejunal autograft can be recommended but it has to be performed by highly experienced professionals due to risky surgical complications.