The etiology of esophageal cancer is complex and multifaceted, and the specific mechanism of occurrence is still unclear. Generally speaking, esophageal cancer is not a direct genetic disease. The specific pathogenesis of esophageal cancer is not yet clear, but it is generally believed that the main risk factors for esophageal cancer include fast eating, food that is too hot or too spicy, physical factors such as poor oral hygiene, smoking and long-term exposure to nitrosamines. Many diseases have family aggregation and will be inherited to offspring, however, esophageal cancer is not a direct hereditary disease. Although research on high incidence of esophageal cancer has found that very few families with esophageal cancer are related to hereditary factors, and about one third of such families have successively developed esophageal cancer with the same incidence rate of men and women, in fact, there are not many such families. Therefore, people with family history of esophageal cancer should realize that although they may suffer from esophageal cancer due to heredity, it does not mean that they will definitely get esophageal cancer, so they should avoid unnecessary panic. In conclusion, esophageal cancer is not a direct hereditary disease, but the occurrence of esophageal cancer is influenced by genetic factors to a certain extent. Therefore, we should pay attention to develop good dietary habits and avoid too cold, too hot and too spicy diet to prevent the occurrence of esophageal cancer and strive to achieve early detection, early diagnosis and early treatment.