Esophageal cancer, also known as esophageal cancer, is a malignant tumor. Currently, there are several treatments for esophageal cancer, including surgery, radiation therapy, chemotherapy, immunotherapy, biotherapy, targeted drug therapy, and combined radiotherapy and chemotherapy. The most reasonable treatment plan should be formulated according to the specific condition of patients with mid- to late-stage esophageal cancer. The first treatment plan for patients with mid- to late-stage esophageal cancer should be surgical resection treatment, which mainly aims at improving clinical symptoms, improving life quality, reducing pain and prolonging life. If the location of the tumor is suitable for surgical resection, the patient’s physical condition can tolerate the surgery and there are no other contraindications to surgical treatment, surgical resection should be chosen first, and the tumor can be completely removed and the surrounding lymph nodes can be cleared to achieve better treatment purpose. After surgery, local radiotherapy and chemotherapy are also needed to prevent tumor recurrence or metastasis according to the specific pathology and clinical staging. Patients who cannot be removed at once by surgical treatment can be treated with tumor reduction surgery or adjuvant therapy before surgical removal to control the growth and spread of tumor. For patients who cannot be surgically removed, palliative surgery, such as gastrostomy, can be performed to improve the quality of life. If the patient is old and frail, has contraindications to surgery, or surgery may not be effective, surgery will not improve the patient’s clinical symptoms and may cause the aggravation of the disease, local radiotherapy combined with chemotherapy and targeted drug therapy can be performed to reduce the patient’s pain and inhibit the spread of cancer cells. Therefore, in the treatment of patients with mid- to late-stage esophageal cancer, surgical resection treatment is the primary choice, and surgical treatment can be carried out as much as possible, and other treatments can be used to improve the efficacy after surgery. If the best time for surgery is lost, then radiation therapy and chemotherapy can be considered.