The exact cause of esophageal cancer is still unclear, and the causes leading to the occurrence of esophageal cancer are complex and multifaceted. Esophageal cancer is one of the common gastrointestinal tumors in China, and the specific mechanism leading to its specific occurrence and development is not yet clear. The distribution of esophageal cancer in China is geographically specific, and the high incidence area is mostly distributed in the border area of Henan, Hebei and Shanxi provinces in the southern section of Taihang Mountains. Some studies have proved that smoking and alcohol consumption have been proven to be important causes of esophageal cancer. Some studies in the past also considered esophageal cancer to be related to physical factors such as eating too fast, food that is too hot and spicy, and poor oral hygiene. Moreover, the main risk factor is also associated with exposure to nitrosamines. Long-term consumption of food containing mold can also promote the development of esophageal cancer. Some benign esophageal diseases, such as cardia loss retardation, esophageal diverticulum, scar stenosis after chemical burns of esophagus, esophageal reflux, etc. can stimulate abnormal proliferation of esophageal mucosa and complicate esophageal cancer. Other causes include lack of certain trace elements and vitamins in food, poor dietary habits, genetic factors, etc. In conclusion, the etiology of esophageal cancer is complex and multifaceted. We should develop good living habits, diagnose and treat some benign esophageal diseases as early as possible to avoid the occurrence of esophageal cancer.