The early presentation of esophageal malignancy is always negligible, predominately dysphagia or body weight loss. A 78-year-old male patient presented with globus pharyngeus for 2 months. Dysphagia or body weight loss was not noted. Initially, gastroesophageal reflux was impressed; however, after 3 weeks' anti-reflux therapy, the symptom was not relieved. Then, fiberoptic esophagoscopy showed a protruded tumor in the lower segment of esophagus with squamous cell carcinoma in the pathological study. Stage I, T1N0M0 esophageal carcinoma was confirmed after computed tomography scan, abdomen ultra-sonography, and whole body bone scan were performed. Because of age, he was scheduled for concurrent chemo-radiotherapy; however half a year later, he was died of radiation pneumonitis and septicemia. In conclusion, esophageal malignancy should be ruled out by esophagogram or gastroesophagoscopy if conservative treatment fails to cure an aged man's globus pharyngeus.