Abstract: Primary esophageal adenocarcinoma is rare.From Nov.1975 to Dec.1991,2456 cases carcinoma of esophagus were resected and 27 cases(1.1%,27/2456) with esophageal adenocarcinoma were histologically confirmed.Esophageal adenocarcinoma is of three origins:esophageal intrinsic gland,ectopic mucosa,and Barrett's esophagus.This adenocarcinoma may be subdivided into simple adenocarcinoma.adenosquamous carcinoma,mucoepdermoid carcinoma,and adenoid cystic carcinoma.Simple adenocarcinoma and adenosqumous carcinoma were most amount in four types above(26/27).Of all 27 cases follow-up:1,2.3,4-year survival rate was 66.7%(18/27),34.6%(9/26),19.0%(4/21) and 7.7%(1/3) respectively.No 5-year survival rate.The pregnosis was more worse than that of the sequmous cell carcinoma of esophagus.The author consider early operation would be held and cervical esophagogastrostomy after resected of all thoracic esophagus would be,adapted for patients diagnosised with esophageal adenocarcinoma.