OBJECTIVE： To observe the clinical effect of elemene for esophageal carcinoma in three-dimensional conformal radiotherapy. METHODS： 92 patients with esophageal carcinoma were randomly divided into research group （50 cases） and control group （42 cases）. Control group received three dimensional conformal and Sanye irradiation treatment； research group was additionally treated with Elemene injection intravenously， 600 mg/time， qd， for consecutive 1 month， on the basis of control group. Clinical efficacies of 2 groups were observed one month later. With a year to 3 years of follow-up， the local control rate and survival rate of 2 groups were calculated； QLQ-C30 and QLQ-OES18 were used to evaluate the survival quality and symptom improvement； the occurrence of adverse events were observed in 2 groups during treatment. RESULTS： The effective rate of research group was 88.0％ and increased significantly compared to control group （66.7％）， with statistical significance （P＜0.05）. With 1， 2 and 3 years of follow-up， local control rate and survival rate of research group were higher than those of control group， without statistical significance （P＞0.05）. The body， emotion， role， society and cognition score of research group were significantly higher than those of control group， while fatigue， dry mouth， deglutition obstruction， eating， loss of appetite and dysphagia score were significantly lower than control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of adverse events between 2 groups （P＞0.05）. CONCLUSIONS： Elemene combined with three-dimensional conformal radiotherapy shows definite short-term and long-term efficacy and is highly safe for esophageal carcinoma， and it contributes to the improvement of survival rate and survival quality.