Abstract: Objective To explore the survival difference among premenopausal, perimenopausal and postmenopausal female and the relationship between menopausal status and invasion and lymph node metastasis in esophageal cancer. Methods The questionnaire, home interview and/or telephone were performed for survival follow-up on esophageal cancer patients. The Chi-square test, Kaplan-Meier survival curve,Log rank test and multivariate Cox regression model were applied to assess the survival of all female esophageal cancer from 1973 to 2012. Results The survival time in premenopausal patients (age of diagnosis <46 years, n=201), peri-menopausal (age of diagnosis 46-55 years, n=949) and postmenopausal (age of diagnosis>56 years, n=3 284) were signifi cantly decreased successively (P <0.001). It was noteworthy that the tumor invasion (T) was no difference in premenopausal, perimenopausal or postmenopausal (P=0.243), however, the lymph node metastasis rate was successively increased successively in premenopausal, perimenopausal and postmenopausal (P=0.022). Cox multivariate survival analysis showed that menopausal status, lymph node metastasis and invasion were independent prognostic factors in female patients with esophageal cancer. Conclusion Menopausal status was independent prognostic factor for female patients with esophageal cancer. Lymph node metastasis was related to menopausal status.