Esophageal granular cell tumors (GCTs) are rare and often misdiagnosed. GCTs generally located at middle and distal of the esophagus in middle aged and elderly patients. Histologically, tumor cells were mainly plump and polygonal with abundant, granular, amphophilic or eosinophilic cytoplasm. The growth pattern was solid or nested. Most cases reported in the literature so far were small in size and managed with endoscopic procedures. However, here we report a case of GCT causing near total obstruction arising extraluminal layer of the cervical esophagus. 42-year-old woman referred from the Department of Gastroenterology with the impression of upper esophageal spasm after the failure of four times of endoscopic dilatation. The patient had progressive dysphagia for six months. Esophageal manometry or computed tomography could not suspect the lesion at the cervical esophagus. Operation was done at our department for the purpose of cricopharyngeal myotomy. However about 5X4 sized mass on the outer muscle layer of the cervical esophagus and hypopharynx extending near recurrent laryngeal nerve was detected and resected transcervically. Dysphagia was liberated right after the surgery.