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Oesophageal surgery is the current standard for advanced oesophageal cancer within multimodal protocols involving perioperative chemoimmunotherapy and/or radiotherapy. However, oesophagectomy is afflicted with significant morbidity and mortality so that organ-preserving strategies would be worthwhile to develop. We report a case of advanced oesophageal squamous cell cancer (cT2) treated by neoadjuvant therapy and presumably downstaged to a superficial lesion. Semicircumferential endoscopic full-thickness resection (EFTR) was performed, followed by implantation of a metallic stent. Histology showed residual intramucosal high-grade dysplasia. Three months postoperation, the wound healed well, with no occurrence of oesophageal stenosis. The patient received immunotherapy until 24 months post-EFTR and has been followed for 26 months without the recurrence of the disease. Further studies have to show the oncological success, but also oncological risks associated with such an innovative approach.