BACKGROUND Using deep learning techniques in image analysis is a dynamically emerging field. This study aims to use a convolutional neural network (CNN), a deep learning approach, to automatically classify esophageal cancer (EC) and distinguish it from premalignant lesions. METHODS A total of 1,272 white-light images were adopted from 748 subjects, including normal cases, premalignant lesions, and cancerous lesions; 1,017 images were used to train the CNN, and another 255 images were examined to evaluate the CNN architecture. Our proposed CNN structure consists of two subnetworks (O-stream and P-stream). The original images were used as the inputs of the O-stream to extract the color and global features, and the pre-processed esophageal images were used as the inputs of the P-stream to extract the texture and detail features. RESULTS The CNN system we developed achieved an accuracy of 85.83%, a sensitivity of 94.23%, and a specificity of 94.67% after the fusion of the 2 streams was accomplished. The classification accuracy of normal esophagus, premalignant lesion, and EC were 94.23%, 82.5%, and 77.14%, respectively, which shows a better performance than the Local Binary Patterns (LBP) + Support Vector Machine (SVM) and Histogram of Gradient (HOG) + SVM methods. A total of 8 of the 35 (22.85%) EC lesions were categorized as premalignant lesions because of their slightly reddish and flat lesions. CONCLUSIONS The CNN system, with 2 streams, demonstrated high sensitivity and specificity with the endoscopic images. It obtained better detection performance than the currently used methods based on the same datasets and has great application prospects in assisting endoscopists to distinguish esophageal lesion subclasses.