Dysplasia in Barrett's esophagus (BE) occurs as a flat, grossly undetectable lesion. Dysplasia growing as a polypoid lesion in BE is extremely rare. Only a handful of cases are reported in the literature. BE associated polypoid dysplastic lesions have been referred to as "adenomas" because of their histologic similarity to a colonic adenoma. We describe a patient with esophageal polypoid lesion associated with BE and review clinical and pathological features of other cases of BE associated polypoid dysplasia or "adenomas" as reported in the literature.