Abstract: Objective : To analyze the clinical manifestation, pathological features and surgical treatment of primary small-cell esophageal carcinoma. Methods : A total of 73 cases with primary small-cell esophageal carcinoma were retrospectively analyzed. Results : The overall resection rate and radical-excision rate were 94.5% and 89.0%, with 1.4% of perioperative mortality. The 1-, 3- and 5-year survival rate were 50.7%, 13.7% and 8.3%, respectively. Conclusion : The primary small-cell esophageal carcinoma is an uncommon malignant tumor due to its early metastasis and poor prognosis. Based on our clinical findings, surgical treatment combined with postoperative chemotherapy benefit to the stage-Ⅰ or Ⅱ disease, for the patient in stage Ⅲ or Ⅳ might be responsible for radiochemotherapy.