Introduction:The incidence of esophageal cancer has been increasing in the last decade. Different types of treatments are available, including minimally invasive esophagectomy (MIE). The aim of this study was to compare the early outcomes of the open vs totally laparoscopic transhiatal esophagectomy. Materials and methods: This case-control study was conducted between May 2012 and January 2014. Patients with esophageal cancer who presented to Imam Reza Hospital, Mashhad, Iran, were assessed and their eligibility for the surgery type was investigated. Results: Ninety-three esophagectomies performed. The open group comprised 57 patients and the laparoscopic group consisted of 36 patients. Mortality occurred in three patients in the open group and seven patients in the laparoscopic group (p < 0.05). Chylothorax happened in four patients in the open group and only in one patient in the laparoscopic, which showed no significant difference. The mean operating time was 75 ± 16 minutes in the open group and 125 ± 25 minutes in the laparoscopic group (p < 0.05). Conclusion:Minimally invasive transhiatal esophagectomy is an available option for treatment of esophageal cancer, but our results should be interpreted with caution due to low sample size and our primary experience in patient selection.