Esophageal gastrointestinal stromal tumors (GIST) are rare, and complete surgical resection is the standard treatment. Because of their rarity, the natural clinical course, management, and prognosis of esophageal GISTs remain unclear. In particular, small (<2 cm) esophageal GISTs and microGISTs (<1 cm) pose management challenges. We report the case of a 55-year-old female. Her esophageal microGIST, located in the upper third of the esophagus, maintained a stable size of 0.8 cm for 5 years. The pathological risk assessment for this lesion was "very low risk of malignancy." We present the case of this patient and review the relevant literature.