Esophageal perforation caused by radiotherapy for esophageal cancer can be cured if it is detected in time and treated early. After receiving radiotherapy for esophageal cancer, esophageal tissues will be necrotic and disintegrated, and the wall of esophagus will become fragile, so esophageal perforation may occur. There are hollow organs such as trachea and arteries next to the esophagus, so esophageal-tracheal fistula, esophageal-pleura fistula, esophageal-aortic fistula and so on may form after perforation, which may be fatal in serious cases. After perforation, the patient should stop eating through the mouth, use nasoenteric tube or jejunostomy, stop radiotherapy, and observe the patient for about 1 month to evaluate the condition and treatment again. After conservative treatment, most patients can have the perforation closed in about 1 month, and esophageal stents can be implanted if necessary. Perforation caused by radiotherapy for esophageal cancer can be cured in most patients after active treatment, but it has influence on patients’ eating and whether they can undergo chemotherapy in the following period, and may even affect their survival period.