Objective To evaluate the accuracy and investigate the influence factors of preoperative T staging by endoscopic ultrasonography (EUS) in patients with postoperative pathological stage of T2 esophageal carcinoma (EC). Methods A total of 206 patients with EC underwent EUS and curative operation in Henan Tumor Hospital from March 2015 to January 2016 were enrolled, among whom 81 patients were identified with pathological stage of T2 EC followed by esophageal resection without induction therapy. There were 59 males and 22 females, with a mean age of 63.9 years and meadian age of 63.0 years. We reviewed the medical records of the 81 patients and compared EUS findings with histopathologic results according to clinicopathologic factors. Results The overall accuracy of EUS for evaluating staging of T2 EC was 61.7% (50/81), while 38.3% (31/81) were overstaged by EUS. Accuracy differed between the accurate staging group and over staging group (P=0.023). There was no significant difference in sex, age, tumor location and shape, histologic type, tumor differentiation or lymph node metastasis between two groups. Conclusion EUS is highly overstaged in the diagnosis of postoperative pathological stage of T2 EC. Higher postoperative pathological TNM stage appears to be a factor of EUS overstaging in patients with postoperative pathological stage of T2 EC.