Abstract: Objective: To explore a rational therapy for recurrent esophageal carcinoma after radical radiotherapy. Methods: The clinical data of 21 patients with esophageal carcinoma having received esophagectomy were analyzed and compared with those of 22 patients treated by conservative therapy. Results: Twenty cases in the surgery group( 95. 2%) underwent esophagectomy. Postoperative hyoxemia occurred in 15 cases,anastomotic leakage in 1 case and pulmonary infection in 2 cases. The 1,3 and 5-year survival rate was 71. 4%,33. 3% and 14. 3% respectively in the surgery group,while the 1-year survival rate was 45. 5% in the conservative treatment group,the difference was not significant( P 0. 05),no one in the conservative treatment group survived after 2 years,and their survival duration was 2- 17 months. The satisfaction degree half-year after the recurrence was 66. 7% in the surgery group,which was significantly higher than the 27. 3% in the conservative treatment group( P 0. 01). Conclusions: Surgery is of great risk for patients with recurrent esophageal carcinoma after curative radiotherapy,so attentive peril-operation preparation is essential. Operation may bring survival benefit to those patients.