We welcome patients to visit the Cardiothoracic Surgery Department of Tianjin Medical University General Hospital or through our online consultation, Dr. Dong’s consultation website. We will promptly answer your questions, formulate individualized treatment plan and provide the next treatment plan according to your condition as much as possible. In China, surgery is still the main treatment for esophageal cancer, however, the prognosis of patients with locally advanced esophageal cancer is still unsatisfactory, which has prompted physicians to explore the inclusion of radiotherapy, chemotherapy or radiotherapy in the treatment plan. From the current studies, neither postoperative chemotherapy nor radiotherapy has improved the prognosis of esophageal cancer patients, and there is no sufficient evidence for the effectiveness of preoperative radiotherapy, but preoperative neoadjuvant therapy, including preoperative radiotherapy and preoperative chemotherapy, especially the former is expected to improve the prognosis of esophageal cancer patients. Therefore, the Chinese Guidelines for Standardized Diagnosis and Treatment of Esophageal Cancer have put preoperative neoadjuvant therapy in an important position. This article will introduce the principles and evidence-based medical basis of preoperative neoadjuvant therapy for esophageal cancer.