Abstract: Objective To evaluate the safety and efficacy of neoadjuvant chemoradiation for elderly patients (age≥70) with local advanced esophageal squamous carcinomas. Methods A total 27 elder patients staged cT3N0~1(group A) were analyzed retrospectively compared with 62 cases of younger patients(group B),all of them were given 2 cycles cisplatin 75 mg/m2 plus fluorouracil 600 mg/m² d1～5 and 40 Gy of radiation followed by surgery 3~4 weeks later in past two years. Results All patients accomplished planned neoadjuvant chemoradiations.Neoadjuvant chemoradiation caused vomiting,neutropenia and esophagitis in two arms similarly,only G3/4 neutropenia occurred in 25.9%(7/27) of group A versus 8.1%(5/62) of group B (P=0.023).The effective rate of neoadjuvant chemoradiation was 92.6%(25/27) in group A vs.95.2% in group B (P=0.621).88.9% patients （24/27）underwent complete resection of group A and 87.1%(54/62) of group B (P=0.563).No mortality was found.The overall complication rate were similar in two groups (32.0% vs.22.0%).Arrhythmia，pneumonia and injury of recurrent laryngeal nerve were the common complications after surgery.The incidence of arrhythmia in group A occurs was 32.0% contrast to 8.5% in group B (P=0.015).There was no difference of pCR between two groups (25.9% vs.22.6%). Conclusion There was no significant difference between elderly patients and younger patients with local advanced esophageal squamous carcinomas treated by neoadjuvant chemoradiation followed by surgery,though increased G3/4 neutropenias and arrhythmias.The neoadjuvant chemoradiation was safety and effective for elderly patients.