Abstract: Objective To evaluate the effect of different radiotherapy methods for mediastinal metastasis from esophageal carcinoma after surgery. Methods From January 1998 to December 2005, 145 cases treated with irradiation were classified into group A (conventional radiotherapy), group B (three-dimensional conformal radiotherapy) and group C (semi-conformal radiotherapy). Results (1) The difference of age constituent ratio between group B and group C was significant (P=0.044). (2) The local control rates of group A, B and C were 63.8%,89.6% and 77.4%, respectively. The local control rate of group A was lower than that of group B (P=0.001). (3) The 1, 2, 3-year survival rates of group A, B and C were 55.6%,21.5%,12.0%，40.8%,17.3%,12.6% and 48.4%,25.8% and 16.1%, respectively. The difference of 1, 2 and 3-year survival rates of group A, B and C was not significant (P=0.575). (4) The rates of side-effect of radiation were 16.6%（24/145）to grade 1, 51.0%（74/145） to grade 2 and 32.4%（47/145）to grade 3, respectively. The difference of that of group A, B and C was not statistically significant (P=0.483). Conclusion Three-dimensional conformal radiotherapy can markedly improve the local control rate, but has not significantly improved the survival rate and descending the side-effect rate of patients with mediastinal metastasis from esophageal carcinoma after surgery.