Abstract: Objective : To study the characteristics of para-recurrent laryngeal nerve lymph node metastases from thoracic esophageal carcinoma and their influence on patient prognosis and to determine the optimal extent of regional lymph node excision. Methodse : The clinical materials of 120 patients who underwent resection of thoracic esophageal carcinoma were retrospectively analyzed. Results : Para-recurrent laryngeal nerve lymph node metastases were found in 41 of these 120 cases (34.2%), with the rate of left and right para-recurrent laryngeal nerve lymph node metastasis of 20.8% and 15.8%, respectively. Tumor location, tumor differentiation and the depth of tumor invasion were factors influencing para-recurrent laryngeal nerve lymph node metastasis (P<0.01). The para-recurrent laryngeal nerve lymph node metastases were associated with cervical lymph node metastases. The postoperative cervical lymph node recurrence rate was 8.3%. The 3-year survival rate of patients with para-recurrent laryngeal nerve lymph node metastasis was 29.3%, much lower than that of patients without para-recurrent laryngeal nerve lymph node metastasis (58.2%) (P<0.05). Conclusion : During surgery for thoracic esophageal carcinoma, para-recurrent laryngeal nerve lymph nodes should be resected, a procedure that can improve prognosis and decrease local recurrence postoperatively.