Barrett’s Esophagus (BE) is the precursor lesion of esophageal adenocarcinoma, which has a poor survival rate while having the fastest growing incidence of any cancer in the United States. Identifying patients with BE in the general population and optimizing surveillance programs to treat patients before the onset of adenocarcinoma are significant challenges. Clinical translation of advances in understanding BE pathogenesis and drivers of progression, along with improving pathologic diagnostic accuracy of precancerous lesions, holds promise to improve outcomes. This review highlights current concepts in BE-related surgical and molecular pathology and how these advances are being incorporated into daily clinical practice.