Minimally invasive treatment represents an important breakthrough in the field of early diagnosis and treatment of early gastrointestinal tumors. Endoscopic submucosal dissection (ESD) can achieve complete and en bloc resection of the lesion. It is currently a widely used endoscopic radical treatment method for early gastrointestinal tumors in clinical practice. In recent years, with the continuous development and improvement of ESD technology system, various derivative emerging technologies have emerged, significantly enhancing the efficacy and safety of endoscopic treatment of early gastrointestinal tumors. With the development of artificial intelligence (AI) technology, the introduction of advanced technologies such as AI-assisted diagnosis and robot-assisted operating systems has opened up new directions for the future development of ESD. This article systematically reviews the current application status of ESD in the treatment of various early gastrointestinal tumors, and looks forward to the future development prospects in this field, with the aim of providing more reference for clinical decision-making by digestive endoscopy physicians.