Abstract: Objective:To investigate the long-term risk of esophageal cancer from fresh fruit consumption. Methods:In 1985, a total of 29,479 participants aged between 40and 69years old were recruited for this study. Demographic characteristics, lifestyle, history of diseases, and food intake frequency were surveyed at the baseline and were then followed up. Through December 31, 2015, a median of 31. 79years of observation was obtained. The primary endpoint was death from esophageal cancer. The hazard ratio and 95% confi -dence intervals for fresh fruit consumption were calculated using a Cox proportional hazard model. Results:Overall,31. 09% of partici-pants reported consuming fresh fruit more than once every week. Compared with participants who never or rarely consumed fresh fruit, those who consumed fresh fruit more than once a week had a lower long-term risk of esophageal cancer. Death rate decreased to 7% among those who ate fresh fruit more than once a week, especially among males (11%) and those with positive smoking history (13%).Conclusion: Fresh fruit consumption is associated with a lower risk of death from esophageal cancer, but the etiological mecha -nism needs to be investigated further.