Abstract: Objective To assess the value of trocar sheath in endoscopic removal of date pit at the frst narrowing of esophageal. Methods Medical records of 41 patients admitted to our center for endoscopic removal of date pit at the frst narrowing of esophageal from October 2008 to August 2016 were retrospectively collected and analyzed. Three options could be chosen to deal with date pit:gastroscopy assisted by trocar sheath, gastroscopy alone, and laryngeal endoscope. Average operating time of removing procedure, success rate, incidence of complications in 3 groups were compared. Results Nineteen cases were treated by gastroscopy assisted by trocar sheath with average age of (65.10 ±13.06) years (Among them, 5 cases underwent laryngeal endoscope procedures at frst and failed to remove the pit),and the success rate was 100%. Thirteen cases were treated with gastroscopy alone with average age of (60.62±11.02) years,and the success rate was 76.9% (10/13). Three cases converted to laryngeal endoscope after failed gastrocopic removal and all of them complicated with perforation. Seventeen cases were treated with laryngeal endoscope with average age of (65.18±9.89)years, including 3 cases with unsuccessful gastroscopic removal. The success rate for laryngeal endoscopy group was 76.9% (12/17). Five cases accepted gastroscopy procedure assisted with trocar sheath after failed laryngendoscope removal. Mean time of retrieve procedure was 4.35±0.66 min in trocar sheath assisted gastroscopy group, which was signifcantly less than 8.47±0.92 min in gastroscopy group and 5.85±0.47 min in laryngeal endoscopy group (P< 0.05, respectively). Accuracy rates was 100% in trocar sheath assisted gastroscopy group, which was signifcantly higher 58.8% in gastroscopy group and 58.8% in laryngeal endoscope group (P< 0.05, respectively). Acceptance rates was 89.5% in trocar sheath assisted gastroscopy group, which was signifcantly higher 76.9% in gastroscopy group and 52.9% for laryngeal endoscope group (P< 0.05, respectively). Conclusion Compared to traditionl procedures, trocar sheath assisted gastroscopy could reduce the incidence of complication,increase visual accuracy and shorten the operating time in date pit removal.