1.Esophageal cancer is estimated to be the sixth among the 10 malignant tumor mortality rates in the world, with about 450,000 incidences per year, mainly squamous carcinoma. China is one of the high incidence areas of esophageal cancer in the world, with about 150,000 deaths per year. Surgical resection is the main curative treatment for patients with resectable esophageal cancer. Over the past 30 years, diagnostic modalities, surgical techniques and perioperative management have indeed improved, reducing operative mortality and increasing disease-free survival. The vast majority of patients die due to systemic metastases with local recurrence. This mortality rate has led to a strong exploration of alternative treatments in an attempt to improve outcomes. Where the most appropriate treatment for esophageal cancer is surgery, the best surgical treatment strategy includes patient selection, accurate staging and risk detection, selection of the appropriate surgical pathway, and the use of multiple therapeutic approaches in the management of these patients. Additional factors such as hospital size and surgeon’s experience are also important in reducing the risk of esophageal cancer resection. In addition to traditional methods such as gastroscopy and barium X-ray meal, modern staging methods include CT scan and PET scan, endoscopic ultrasound (EUS) examination. In addition, minimally invasive staging (MIS) with laparoscopy is performed especially in some research units but is not routinely performed. Endoscopic mucosal resection (EMR) is also planned as a staging method. 3.Surgery for esophageal cancer includes open surgery and minimally invasive surgery. Surgery is a safe treatment modality, with an operative mortality rate of 1.5% and a 5-year survival rate of 31.6%. Minimally invasive surgery is developing rapidly, and its quality of life is well maintained. Patients are hospitalized for a short period of time with low mortality rate. 4.Prognosis of esophageal cancer is related to the number of positive lymph nodes removed by surgery, involvement of extra-esophageal lymph nodes, site of positive lymph nodes, degree of differentiation, invasion of lymphatic vessels, and also related to the completeness of resection. 5. Another important factor to improve the outcome of surgical treatment is the level of hospital and surgeon. The first step is to properly diagnose and evaluate the disease in patients with esophageal tumors, and proper patient selection includes accurate staging and patient risk testing. Consensus protocols for appropriate choices are developed by physicians and patients to provide reasonable and accurate information for patients and physicians in the balance of benefit and risk choices.