Abstract: Objective: To further clarify the operation mortality of esophageal carcinoma and to investigate the postoperative main cause of death of the esophageal carcinoma in different time. Metholds: A total of 2572 patients who received resection in our hospital during 50 years (from 1954 to 2003) were reviewed. They were divided into group A for the early 32 years (Jan.1954 to Dec. 1985) and group B for latter 18 years (Jan. 1986 to Dec. 2003). The cause of death for postoperative patients was analyzed. Results: The 44 patients of group A died after operation. The mortality was 8.15% (44/ 540) and 72 patients in group B died after operation, with a mortality of 3.54% (72/2032). Conclusions: The cause of death in group A is the same as in group B. The anastomotic fistula, respiration failure, heart failure, cardiovascular disease is the main cause of death for patients with esophageal carcinoma after operation.