Abstract: To explore the pattern of solitary lymph node ( SLN ) metastasis and its clinical significance in thoracic esophageal carcinoma ( TEC ) and to explore the theoretical basis for determining the scope of lymphadenectomy in TEC. Methods: The clinicopathologic data of 66 successive patients with solitary positive lymph nodes who underwent radical surgery on TEC were retrospectively analyzed. The exact location of the metastasized SLN was studied, and the correlation among the location of SLN, the site of primary tumor, and the depth of invasion was investigated. Univariate analyses were used to evaluate the prognostic factors in the patients. Results: In the groups we investigated, the SLN metastasis was most frequently found beside the recurrent nerve and the esophagus as well as around the stomach. There were 20 cases with skipping nodal metastasis ( 30.3% ). The SLN metastasis was limited to two or three areas in the patients with superficial TEC, and was widely distributed in those with advanced TEC, including the lymph nodes in the neck, thorax, and abdomen. The postoperative 5-year survival rates were 36.4% and 42.8 % in the group with SLN metastasis and the group without SLN metastasis, respectively, with significant differences between the two ( P < 0.05 ). The postoperative 5-year survival rates did not show any statistical difference between the group with skipping SLN metastasis ( 35.0% ) and the group without skipping metastasis ( 36.9% ). The univariate analysis showed that the depth of tumor invasion was the independent risk factor affecting the prognosis of the patients in the groups we investigated. Conclusion: The distribution of the positive SLN in TEC is closely related to the tumor location and the depth of tumor involvement. The lymph nodes beside the bilateral recurrent nerve and the paraesophageal and perigastric lymph nodes are the high-risk sites in the nodal metastases.