BACKGROUND: FDG-PET scan has generated in recent years an increasing interest in staging and assessment of response to treatment in cancer patients. METHODS: From the available literature and own data it appears that FDG-PET scan significantly improves detection of haematogenous and distant lymphatic metastasis in carcinoma of the oesophagus and gastro-oesophageal junction (GEJ). Especially diagnostic specificity of lymph node involvement is greatly improved with FDG-PET scan. FDG-PET scan also allows a highly sensitive diagnosis of recurrent disease through its capacity of whole-body staging. In assessing response of induction (chemo +/- radiotherapy) in locally advanced disease FDG-PET scan appears to be of high value in predicting response. RESULTS: Moreover, there seems to be a strong correlation between FDG-PET scan response and survival. CONCLUSIONS: It can be concluded that despite the cost, FDG-PET scan should have a place in the algorithm of initial staging, staging of recurrent disease and assessment of response to treatment in cancer of the oesophagus and GE junction.