The incidence and mortality of esophageal cancer have been among the highest in the world of and elderly patients account for the great proportion. At present，the main treatment for locally advanced esophageal cancer is surgery. However，the elderly patients，with decreased physiological function and a variety of chronic diseases，have often been excluded from clinical trials. Current targeted therapies have not yielded satisfactory results，but the prospects for immunotherapy are worth the wait. Of course，while paying attention to treatment，nutrition support should receive more attention. This review summarizes the current research status and progress of elderly locally advanced esophageal cancer in order to provide reference for the choice of treatment decision.