Objective:To observe the clinical efficacy of chemotherapy for esophageal cancer in the elderly. Methods: A total of 74 patients diagnosed with esophageal cancer in our hospital were randomly divided into the observation group and the control group. The control group was treated with radiotherapy alone, while the observation group was treated with concurrent chemoradiotherapy. The efficacy, adverse reactions and 1 and 2-year survival were observed. Results:The recently response rate was 86.5% in the observation group, while the control group was 62.2% (x2=5.37, P<0.05). The disease control rate was 100.0% in the observation group, while it was 3.8% in the control group. The differences were significant (x2=4.53,P<0.05). The adverse reactions in the two groups were not significantly different. With 34 patients in the observation group followed up, the 1-year survival rate was 73.5%, 2-year survival rate was 55.9%, while it was 40.0% and 25.9% in 35 patients that followed up in the control group. The differences were statistically significant (x2=6.58,x2=5.32;P<0.05).Conclusion: Concurrent chemotherapy for esophageal cancer in the elderly has a significant effect. Compared with radiotherapy alone, it can significantly increase the 1, 2-year survival rate, and does not significantly increase the adverse reactions.