Objective: To describe the cytological findings of the esophagus using sponge cytology as a triage test in patients referred for esophageal endoscopy at Kenyatta National Hospital. Study Design: A cross-sectional descriptive study was undertaken to obtain specimens from the esophagus for cytological evaluation using a sponge. The cellular yield and pattern of esophageal cytological findings was described by cytopathologists using the Bethesda system. The cytological findings were compared with endoscopy findings and whenever possible with biopsy results. Results: All the participants (100%) swallowed the encapsulated sponge successfully and had smears with satisfactory material for evaluation. Negative smears for intraepithelial lesion or malignancy were the most common (86.6%), with intestinal metaplasia reported in 10% of all patients, high-grade squamous intraepithelial lesions in 1.7% and squamous cell carcinoma in 1.7%. There was good agreement between endoscopic and cytological findings. Conclusion: Sponge cytology is a simple and inexpensive technique which seems to have promising results as a primary test as well as a triage test whenever there is any suspicion of an esophageal lesion, especially in clinical settings where endoscopic facilities and medical professionals are not available. Hence, further evaluation using a larger sample size is recommended.