Esophageal carcinoma surgery belongs to high risk subjects. Esophageal carcinoma radical resection and reconstruction is popular in the surgical field and one of the most challenging operations. How to understand, evaluate and treat risks, take corresponding measures, so as to reduce and avoid risks, has been the focus of clinical attention and research. we base on clinical work practices, review the relevant literatures, try to review the risk factors of Esophageal cancer surgery, evaluation methods, risk classification, and its preventive countermeasures for preliminary thinking and discussions, to provide a useful reference to development of a scientific, rational and practical Esophageal cancer surgery risk scoring system.