Esophageal Adenocarcinoma is rare below 30 years of age and if detected at an advanced stage upon presentation, has a poor prognosis. Patients who present with dysphagia early in the disease indicates locally advanced disease and tumor invasion of esophageal musculature. Survival is shorter among younger age group due to biologically more aggressive disease. Goals of management if it has progressed to Stage IV include palliative and supportive care with focus on nutritional build-up, prevention and management of infection and reduction of risk for thromboembolism. Identification of potential risk factors may contribute to the early detection and treatment of the disease.