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A subset of patients with oesophageal cancer shows a marked response to neoadjuvant chemoradiotherapy, yet post-treatment assessment by endoscopy or imaging remains unreliable. We report a 65-year-old patient with major morphological response after neoadjuvant FLOT chemotherapy, a regimen comprising 5-fluorouracil, leucovorin, oxaliplatin and docetaxel, for locally advanced gastro-oesophageal junction adenocarcinoma (tumour, node, metastases (TNM) classification: cT2N0M0), but possible residual disease. The patient chose endoscopic submucosal dissection (ESD) instead of completion surgery. Histology revealed complete response (ypT0). During 15 months of structured surveillance with serial endoscopic and radiological follow-up, the patient remained asymptomatic and disease-free, without local or distant recurrence. Further studies are needed to clarify the role of diagnostic endoscopic resection after uncertain response to neoadjuvant therapy.