The new genetic, biochemical, clinical, and epidemiological data that have recently become available account for the evolution of the generally accepted concept of Barrett’s oesophagus. The definition of this condition proposed in 2014 by the British Society of Gastroenterology taking into consideration the results of the ongoing clinical studies is based only on the description of metaplastic alterations in the oesophagus without regard for their pre-cancer implications. A few strategies for the treatment of the patients presenting with Barrett’s oesophagus have been developed depending on the histological and endoscopic characteristics of metaplastic epithelium taking into account the different pre-cancer potential of the metaplastic segment. As is known, the medication therapy management of Barrett’s oesophagus is based on the application of efficacious proton pump inhibitors (PPI). However, the appearance of pre-cancer changes in oesophageal mucosa of the metaplastic segment (low- and high-degree dysplasia) responsible for the high probability of the formation of oesophageal adenocarcinoma dictates the necessity of the endoscopic treatment including the endoscopic resection and ablation of Barrett’s oesophagus mucosa. To-day, the new methods for the endoscopic intervention are available that are on the one hand highly effective and safe but on the other hand are relatively inexpensive and ensure the high cost/benefit ratio.