Verrucous carcinoma of the esophagus is a very rare entity. It has a high mortality. Treatment is different. 14 cases are reported. With this 15th case we report on a 66-year-old female with a verrucous carcinoma of the esophagus and surgical treatment after 4 times of recurrence and unsuccessful endoscopic resection of the tumor. The patient received transthoracic removal of the distal esophagus and interposition of the stomach. The patient recovered completely and was discharged from hospital after 18 days. Considering this case therapeutic options will be discussed.