Purpose: Oesophageal cancer is an aggressive malignancy with poor survival outcomes. This study aimed to compare the morbidity and mortality rates of oesophagectomies performed at a regional New Zealand hospital against international benchmarks to inform the debate on centralisation of oesophagectomy services in New Zealand. Methodology: A retrospective audit was conducted on patients who underwent oesophagectomy at Tauranga Hospital between January 2014 and December 2023. Mortality and complication rates were compared with those from the Esophageal Complications Consensus Group (ECCG). Data were analyzed using R studio, and statistical significance was assessed with Fisher-Exact, Chi-Squared, and ANOVA tests. Results: Sixty-one patients were included, with a mean age of 65 years. The 30-day mortality rate was 0% (benchmark 2.4%) and the 90-day mortality rate was 1.6% (benchmark 4.5%). However, complication rates were higher, with anastomotic leaks occurring in 16.4% (benchmark 11.4%) and Clavien-Dindo grade ≥ 3B complications in 26.2% (benchmark 17.2%). No significant differences were found when stratified by age, comorbidity, or treatment. Conclusion: This study demonstrated acceptable outcomes in a small sample of regional oesophagectomies and suggests further regional research is warranted. Other low-volume regional hospitals with high service capabilities that perform oesophagectomies alongside similar complex oncological resections may consistently achieve acceptable outcomes, supporting the continuation of regional oesophagectomy services in New Zealand. This in turn could maintain rural access to specialist services and reduce inequity.