Objective To evaluate the clinical efficacy and toxicities of three dimensional conformal radiotherapy combined with chemotherapy for advanced esophageal carcinoma. Methods We retrospectively reviewed 127 patients with advanced esophageal squamous carcinoma in our department from January 2008 to January 2011,who were divided into two groups:conformal radiotherapy combined with chemotherapy(RCT) group,69 patients and radiotherapy(RT)group,58 patients. The side effects,quality of life and effective rates of them were compared. Results The severe rate of the marrow toxic effect and the incidences of radia-tion-induced esophagitis were higher in the RCT group(29. 0% vs 12. 1% ,χ2 = 5. 387,P = 0. 020;24. 6% vs 10. 3% ,χ2 = 4. 341,P = 0. 037). Patients in the RT group had better quality of life than those in the RCT group in gastrointestinal side effects(nausea,vomiting,diarrhea)and food intake(73. 9% vs 12. 1% ,χ2 =48. 574,P = 0. 000;43. 5% vs 25. 9% ,χ2 = 4. 274,P = 0. 039). In the RCT group,the effective rate was 91. 30%(63 / 69)and 72. 41 %(42 / 58)in the RT group,with a statistical significance(χ2 = 7. 852,P =0. 005). Conclusion Three dimensional conformal radiotherapy combined with chemotherapy for advanced esophageal carcinoma can improve the short-term curative effects,but it also increase the acute toxic effect. Further follow-up studies are needed for its long-term effect.