Abstract: Objective: To investigate the expression of Survivin and COX-2 in esophageal squamous cell carcinoma (ESCC) and to determine if there is a correlation between these expression levels and clinicopathologic factors. Methods: The presence and the level of expression of Survivin and COX-2 were detected by S-P immunohistochemistry in 51 ESCC specimens and 30 specimens from the incision margin (TIM). The expression levels of Survivin and COX-2 were analyzed in relation to the clinicopathologic factors. Results: The positive staining rates of Survivin and COX-2 in ESCC and TIM were 74.51% and 6.67%, 56.86% and 16.67%, respectively. Survivin and COX-2 were expressed at significantly different levels in ESCC and TIM (P <0.01). The positive rates of Survivin expression were associated with the differentiation grade of ESCC(P <0.05), but were not associated with gender, age, tumor size, depth of invasion, TNM stage or lymph node metastasis(P >0.05). The positive rates of COX-2 expression were not associated with gender, age, tumor size, differentiation, depth of invasion, TNM stage or lymph node metastasis (P >0.05). The expression of Survivin in ESCC was positively correlated with that of COX-2 in the 51 ESCC samples(P<0.01). Conclusion: Both Survivin and COX-2 are overexpressed in ESCC and this overexpression seems to be an early event in the development of ESCC.Moreover, expression of these two gene products is positively correlated. Survivin and COX-2 might share a common molecular pathway or enhance each other's actions in the development of ESCC. The molecular basis of such a relationship should be investigated further.