Abstract: Objective To compare the efficacy of neoadjuvant chemoradiotherapy (CRT) combined with surgery and surgery alone on local advanced esophageal cancer. Methods Eighty patients with esophageal cancer at stageⅡA-Ⅲ were equally randomized into neoadjuvant CRT plus surgery group and surgery group. CRT was given as two chemotherapy courses by cisplatin 75 mg/(m² ·d) on d1 and 5-fl uorouracil 500 mg/(m² ·d), from d1 to d5 as continuous infusion. The first chemotherapy and the first radiotherapy were applied on the same day. One course was given every 3 weeks. Two courses were given concurrent with radiotherapy. Radical surgery for esophageal carcinoma was applied for 4 weeks after chemoradiotherapy. Planning target volume in radiotherapy was given 2.0 Gy/fraction and total dose of 40 Gy. Overall survival was analyzed by Kaplan-Meier. Log rank was applied to compare between two groups . Results There were more complications in neoadjuvant CRT plus surgery group than those in surgery group,without statistic differences. 1-, 2- and 3-year overall survival rates were 83.3％, 65.3％ and 42.8％ in neoadjuvant CRT plus surgery group, and 80％, 41.6％and 25% in surgery group, respectively(P=0.023). Conclusion Compared with surgery alone, neoadjuvant CRT plus surgery could improve overall survival rate of local advanced esophageal cancer, with no signifi cant postoperative complications.