Esophageal material for cytologic smears was obtained by the gel-foam technique from an 84-year-old man with dysphagia and symptoms of obstruction in whom initial attempts at endoscopic biopsy were nondiagnostic. The smears contained cells with koilocytotic atypia, similar to those described in smears from uterine cervix lesions produced by human papilloma virus. The cytologic diagnosis of an esophageal papilloma of viral origin was confirmed by the second biopsy. A third biopsy, from a lower level of the esophagus following dilatation procedures, revealed an epidermoid carcinoma in situ contiguous with the papilloma.