Peroral tumorectomy (POET) expands upon previously described endoscopic tunneling procedures to allow for resection of submucosal lesions within the esophagus, esophagogastric junction, and gastric cardia. Peroral tumorectomy involves the creation of a submucosal tunnel proximal to the lesion followed by the use of electrocautery to completely dissect the tumor free of adherent muscle. This technique allows for the safe en bloc resection of submucosal lesions while maintaining the mucosal barrier directly above the tumor. Previously reported rates of complete pathologic resection range from 80% to 100%. The procedure provides the added benefit of being far less invasive than traditional minimally invasive resection techniques for submucosal tumors located in the esophagus, esophagogastric junction, and gastric cardia. Rates of postoperative complications (e.g., hemorrhage, pneumothorax, pleural effusion) reported in the literature are low (<8%). As a result, peroral tumorectomy is a safe technique for providing potentially curative resection of small submucosal lesions in anatomically challenging portions of the foregut.