A 68-year-old man with long-segment Barrett’s esophagus (BE) repeatedly failed to achieve re-epithelialization after endoscopic mucosa resection (EMR) and multiple radiofrequency ablation (RFA) sessions. During follow-up, he developed intramucosa carcinoma with multiple non-visible high-grade dysplasia (HGD) in random biopsies. Circumferential salvage endoscopic submucosal dissection (ESD) for the entire BE was performed using a bipolar knife with tunnel creation and clip-band-line traction to enhance visualization. Microwave coagulation minimized bleeding, and the 459-minute procedure was completed safely despite the severe fibrosis. Stricture prevention included triamcinolone injection and Purastat polymer application, followed by high-dose proton-pump inhibition and oral viscous budesonide for 12 weeks. This multimodal approach effectively reduced stricture risk after circumferential ESD.