Objectives: To assess the early out come of Transhiatal oesophagectomy for carcinoma of the middle and lower third oesophagus. Material And Methods: This observational study was carried out in Cardiothoracic surgery unit, Lady Reading Hospital, Peshawar, from January 2006 to December 2007.50 patients of either gender and any age with a diagnosis of oesophageal carcinoma, willing to participate, were included in the study. Patients with serious co-morbidity, cervical and upper thoracic oesophageal tumors, locally advanced irresectable and metastatic disease were excluded from the study. All the cases were assessed and operated upon by an experienced surgeon using transhiatal approach. The demographic data, clinical features, radiologic, pathologic and operative findings, out come of the procedure in terms of postoperative complications, 30 day mortality and duration of ICU and hospital stay were recorded on a proforma. The data was entered and processed on the SPSS 10 version. Results: Study included 28 males and 22 females. Male to female ratio was 1.2 7:1. Mean age was 57 years, with a range of 27 to 75 years. Mean operative time was 125 minutes with mean blood loss of 600 ml. Uncontrollable per-operative hemorrhage necessitating thoracotomy occurred in 2% (n=1). Anastomotic leak occurred in 8% cases, aspiration pneumonia in 4% and transient hoarseness in 4% patients. One patient (2%) died postoperatively from aspiration pneumonia. Mean ICU stay was 2 days; mean postoperative hospital stay was 9 days. Conclusion: Transhiatal oesophagectomy is a safe approach for carcinoma of the middle and lower third oesophagus. It has acceptable early postoperative morbidity and mortality.