At present, an endoscopic resection is a mandatory treatment method for early esophagogastric and intestinal tumors. Especially, the importance of endoscopic submucosal dissection (ESD) is increasing rapidly. To accomplish a successful ESD procedure, the handling of resected specimens and their pathological evaluation are quite important. Japanese gastroenterologists and pathologists have worked together for the high-quality assessment of resected specimens and established a thorough and careful examination method that is a standard in Japan. In this presentation, I would like to introduce the procedure of the handling ESD specimens and emphasize their implication in practical medicine.