Abstract: The incidence of esophageal cancer in elderly patients has been increasing each year because of the aging society. Esophageal cancer in elderly patients has become a common clinical disease. Because physiological hypofunction and consequent aging- or treatment-related complications are always observed in elderly patients, it is necessary to consider the applicable treatment strategy and intensity after these patients have undergone a complete evaluation. Radiotherapy is currently one of the most important treatment strategies for elderly patients. Here, we review the progress in the use of surgery and radiotherapy combined chemotherapy and other treatments for esophageal cancer in elderly patients.