A new technique for dilation of the upper gastrointestinal tract permits complete endoscopic control of the whole procedure for the first time. 113 dilations have been carried out in 37 patients within a period of 15 months. The endoscopic guidance of the multiple diameter bougie positively excludes perforation resulting from the bougie's going the wrong way. With the steerable tip of the endoscope, kinking can be overcome and stenoses down to the duodenum can be dilated.