Esophagogastric junction (EGJ) cancer shows a rising incidence in Western countries. It is diagnosed by endoscopy and classified into Siewert type I-III carcinoma based on its location in relation to the anatomical cardia. Apart from endoscopic resection of early stage carcinoma, surgery is the treatment of choice. The common surgical approach for Siewert type I carcinoma is an Ivor Lewis esophagectomy with two-field lymphadenectomy and for Siewert type III carcinoma a transhiatal extended gastrectomy with D2 lymphadenectomy. Minimally invasive procedures show similar oncologic outcomes while mainly pulmonary complications occur less frequently compared to open procedures. A multimodal treatment is standard of care in resectable EGJ carcinoma. Both perioperative chemotherapy and neoadjuvant chemoradiotherapy are treatment options. Systemic chemotherapy is the mainstay of palliative therapy in metastatic or inoperable locally advanced EGJ cancer. Checkpoint inhibitors are emergent immunotherapies and have shown promising results in patients with chemotherapy-refractory advanced and metastatic EGJ cancer.