Esophageal cancer is a common and poorly prognostic cancer, and early screening and early diagnosis arc the keys to improve the prognosis of patients. In recent years, more and more studies have shown that changes in gastrointestinal flora are associated with the occurrence, progression, recurrence, metastasis and chemotherapy resistance of esophageal cancer. This article mainly reviewed the changes of gastrointestinal flora in esophageal cancer patients and the progress of research on gastrointestinal flora in the screening, diagnosis and prognosis of esophageal cancer.