Regarding the diagnosis of esophageal cancer esophageal cancer starts insidiously and may be asymptomatic in the early stage. Some patients have foreign body sensation in the esophagus, or slow or obstructive choking sensation since the passage of food. It may also manifest as burning, pins and needles or pulling pain behind the sternum when swallowing. Progressive esophageal cancer often consults the doctor because of dysphagia, which develops progressively, or even can not eat at all. It is often accompanied by vomiting, epigastric pain, weight loss and other symptoms. In the advanced stage of the disease, long-term insufficient food intake may be accompanied by obvious malnutrition, emaciation and cachexia, and there may be complications such as cancer metastasis and compression. For example, hoarseness caused by compression of recurrent laryngeal nerve, pain caused by bone metastasis; jaundice caused by liver metastasis. When the tumor invades neighboring organs and causes perforation, it can also cause mediastinal abscess and pneumonia. During physical examination, hard abdominal mass can be felt in the upper abdomen or swollen lymph nodes on the clavicle can be touched. The key to cure esophageal cancer is early detection and early treatment. Therefore, those who are over 50 years old and have the feeling of stagnation after eating or difficulty in swallowing should do gastroscopy in time. Middle and late stage cancer is easy to be detected through history, symptoms and signs and laboratory examination; however, early stage cancer has no obvious clinical symptoms and limited lesions, mostly carcinoma in situ or intramucosal cancer, without invasion of muscular layer and lymph node metastasis, so endoscopy and biopsy are needed to confirm the diagnosis. At the same time, it is also necessary to pay attention to the differentiation of esophageal cardia, gastroesophageal reflux disease and benign esophageal stenosis, so as to avoid misdiagnosis. Patients with clinical symptoms suspicious of esophageal cancer should go to the hospital as soon as possible to do gastroscopy, and if the gastroscope does not see obvious lesions, then it should be reassured that esophageal cancer can be ruled out. Early diagnosis and early treatment can improve the prognosis of esophageal cancer. High-grade intraepithelial neoplasia or early carcinoma of the esophagus can be removed by endoscopic stripping resection or local surgery, but ultrasonographic endoscopic evaluation and careful pathological examination of the resected tissues to determine whether the resection is endoscopically clean are necessary. Chemotherapy may be unnecessary if there is no submucosal infiltration. If the margins are not clean a complementary surgical procedure with chemotherapy or radiotherapy is required. Intermediate and advanced cancers emphasize a comprehensive program based on surgery or radiotherapy. For upper esophageal cancer, since it is close to the pharynx, it is difficult to perform surgery, so it is advocated that radiotherapy and chemotherapy should be the mainstay; for middle and lower esophageal cancer, surgical resection should be the mainstay, together with chemotherapy and other symptomatic supportive treatments. If esophageal cancer has reached advanced stage and caused obvious esophageal stenosis and is not suitable for surgical resection, esophageal stent can be placed to solve the feeding problem of patients, and at the same time, tumor progression can be controlled through chemotherapy, immunotherapy and traditional Chinese medicine to prolong life.