Alternative conduits for esophageal replacement become necessary when the stomach is unavailable for use. Common options for conduit creation include the jejunum and the colon. Prior abdominal operations, inflammatory bowel disease, or other mesenteric or abdominal disorders may limit use of either organ and a thorough history is essential when planning for alternative reconstruction. Most often the jejunum is free of intrinsic disease and provides a long segment for esophageal replacement. Limitations on the length of conduit that can be constructed with the jejunum have largely been overcome. A colonic conduit can also provide adequate length to reach the neck.