Objective To observe and analyze the long-term curative effects and complications for early stage thoracic esophageal cancer patients treated with external beam radiotherapy (EBRT) and 252Cf neutron brachytherapy (NBT).Methods From May 2002 to May 2012,26 patients with early stage squamous cell carcinoma who underwent EBRT and 252Cf NBT were respectively analyzed.Patients were treated 5 days per week at 2 Gy/day for a total dose of 50 Gy with EBRT.The total radiation dose to the reference point was 12-16 Gy-eq in 3-4 fractions with 4 Gy-eq/fraction with 252Cf NBT.The 1-,3-and 5-year follow-up rates were all 100 ％.Results The 1-,3-and 5-year survival rates were 95.5 ％,95.5 ％ and 83.5 ％,respectively.The early complication rates for grades 1 and 2 radiation esophagitis were 76.9 ％ (20/26) and 23.1％ (6/26),respectively.The late complication rates for grades 0 and 1 (according to the RTOG/EORTC standard) were 84.6 ％ (22/26) and 15.4 ％ (4/26),respectively.Barium esophagography after treatments confirmed that the complete response rate was 100 ％.Twenty-two patients were confirmed by endoscopy to have either normal mucosa or inflammation change.Conclusion EBRT combined with 252Cf NBT is an effective and safe treatment for early stage esophageal squamous cell carcinoma.