A patient with long-standing cutaneous T-cell lymphoma, mycosis fungoides type (CTCL-MF), developed dysphagia, odynophagia, and weight loss. Endoscopic biopsy of esophageal mucosa demonstrated involvement by CTCL-MF. Although extracutaneous spread of CTCL-MF is common, esophageal involvement is unusual and to our knowledge has not previously been diagnosed antemortem.