The patient is a 39-year-old male who presented with noncardiac chest pain. His evaluation disclosed an esophageal leiomyoma. In this paper we will demonstrate the pre-operative findings and technique for removal of a benign esophageal tumor using hand-assisted laparoscopy. The patient was discharged home 2 days postoperative and returned to work 2 weeks postoperative with complete resolution of his symptoms. Hand-assisted laparoscopy provides a postoperative course that parallels the recovery from conventional laparoscopy. Additionally, the tactile sense that a surgeon looses from conventional laparoscopy is regained by this technology.