Autologous Skin-Grafting Surgery after Super Minimally Invasive Resection (ASGS-SMIR) is a novel endoscopic repair technique developed under the guidance of the Super Minimally Invasive Surgery (SMIS) concept. Based on previous clinical research results and combined with the ten core treatment principles of SMIS, this guideline systematically elaborates on the indications, contraindications, preoperative evaluation, surgical operation standards, postoperative management, and efficacy evaluation system of ASGS-SMIR. This surgery achieves effective repair of large-area mucosal defects and stenosis prevention in the esophagus through the technical process of “skin flap harvesting, mesh processing, sleeve suture, and stent fixation”. The purpose of this guideline is to promote the standardized and normalized application of this technique and provide guidance for clinical practice.