Cancer of esophageal squamous epithelium with severe heterogeneous hyperplasia should be operated in time, and radiotherapy can be considered if it is inoperable. Esophageal squamous epithelium severe heterogeneous hyperplasia carcinoma is esophageal cancer, surgical resection is preferred, and surgical treatment is also the only means that can be cured, as long as the patient’s condition permits, surgical treatment should be actively pursued. As long as the condition of patients allows, they should actively undergo surgery. For patients who are in poor condition or have large lesions and cannot undergo surgery, simultaneous radiotherapy and chemotherapy can be considered, which can achieve better curative effect compared with radiotherapy and chemotherapy alone. Therefore, patients with esophageal squamous epithelial severe heterogeneous hyperplasia should be evaluated comprehensively and the most reasonable treatment plan should be chosen in order to achieve the best therapeutic effect.