In a review article, which includes 67 sources, including 48 domestic and 19 foreign, was analyzed challenges and options overlay esophageal anastomoses after gastrectomy – the most common surgery for stomach cancer. Was described the current requirements for their implementation. Set out the existing methods of the esophageal anastomoses in chronological order. Was shown are the positive and negative sides of the esophageal-duodenal anastomoses, including the use of different versions of "insertions" of the small and large intestine. Was noted the prevalence of esophageal-enteric anastomoses "end-to-end" and allocated their group. Was outlined the advantages and disadvantages of anastomoses: of dangling into the lumen of organ, of made with plastic techniques, of invaginated, of formed by double-row or three-row sutures, of performed using suturing apparatus. Was noted that using of modern and atraumatic needles led to a reduction percentage of insufficiency esophageal-intestinal anastomoses and allowed the introduction technique of single-row suture in the practice which simplifies implementation that minimizes the trauma of the esophageal wall and reduces the time of operative intervention. Was shown author's interest in the prevention of reflux esophagitis, of dumping syndrome, of rumen stricture esophago-enteric anastomosis by performing an antireflux anastomoses. Was noted the importance of overlay of the precision suture, without the seizure of the mucosa which allowing accurate, “joint-to-joint”, to join of the walls of the organs.