Background: Access to fluoroscopic equipment is limited in some regions where esophageal cancer is common. This report describes a simple method for placement of expandable esophageal stents without fluoroscopy. Methods: Patients with dysphagia due to unresectable esophageal cancer underwent esophageal stent placement under endoscopic control alone. A colored mark on the stent delivery catheter was used to properly position the undeployed stent with respect to the proximal end of the tumor. Results: Stent placement was attempted in 70 patients and was successful in every case. There were no immediate complications of stent placement. Mean dysphagia score decreased from 3.3 before stent placement to 0.5 at follow-up. There was a trend toward lower dysphagia scores in patients who received coated stents. Conclusion: Expandable esophageal stents can be accurately and safely placed under direct endoscopic control, without fluoroscopy.