Abstract: Objective:To retrospectively analyze the survival outcomes of the surgical management of primary small cell carcino -ma of the esophagus. Methods:The medical records were reviewed for patients diagnosed with esophageal carcinoma and underwent esophagectomy from January 2000to December 2009at the Department of Thoracic Surgery of the Henan Cancer Hospital. We fo -cused on the clinical data of patients with small cell carcinoma of the esophagus. The Kaplan-Meier approach with log-rank test was used for survival analysis. Results:A total of 5,062 patients underwent esophagectomy with curative intent at the Department of Thorac -ic Surgery of the Henan Cancer Hospital; among which, 57(1.1%) were diagnosed with small cell carcinoma of esophagus. The most common surgical approach was trans-left thoracic incision esophagectomy. Cervical esophagogastrostomy was performed for all pa -tients. The most common chemotherapy regimen was EP. The overall 5-year survival rate was 12.5%, and the median survival time was 45months. Among the various stages, the5-year survival rate and survival time were 25% and 50months for Stage I, 5.9% and 43 months for Stage II, and 4.3% and 43months for Stage Ⅲ. Subgroup analysis showed that cases treated with surgery alone had poorer overall median survival time compared with those cases that underwent surgery plus chemotherapy (23.2 months vs.60.7 months, re-spectively; P<0.01). Even for Stage I patients, the "surgery plus chemotherapy" subgroup was associated with a significantly longer me -dian survival time than the "surgery alone" subgroup (81.9 months vs. 22.3 months,P<0.01). Conclusion:For patients with primary small cell carcinoma of the esophagus, surgery alone cannot provide the optimal prognosis. Surgery combined with systemic chemother -apy can improve the survival time.