Objective: To explore the physical condition, quality of life, and efficacy of esophageal cancer radiotherapy patients with different nutritional status. Method: A retrospective analysis was conducted on 62 patients with esophageal squamous cell carcinoma admitted to Shanxi Cancer Hospital from December 2017 to December 2018. According to the subjective overall evaluation scale developed by the patients, they were divided into a group with good nutritional status (Group A) of 18 cases, a group with mild to moderate malnutrition (Group B) of 25 cases, and a group with severe malnutrition (Group C) of 19 cases. All patients received local radical radiotherapy. Compare the physical condition, quality of life, recent efficacy, and incidence of radiation esophagitis among patients in each group before and after radiotherapy. The Karnofsky score and quality of life score at the end of radiotherapy and 3 months after radiotherapy in Group A were better than those in Group B and Group C (both P<0.05). The quality of life scores of patients in each group decreased at the end of radiotherapy compared to before, and increased three months after radiotherapy compared to before and after radiotherapy. The recent effective rate in Group A was 94.4% (17/18), Group B was 92.0% (23/25), and Group C was 89.5% (17/19). There was no statistically significant difference among the three groups( χ 2=0.778, P=1.00). The incidence of grade 2-3 radiation esophagitis in Group A was 22.2% (4/18), Group B was 24.0% (6/25), and Group C was 68.4% (13/19), with statistically significant differences among the three groups( χ 2=11.534, P=0.003). Conclusion: Nutritional status is related to the patient's physical condition, quality of life, and degree of radiation esophagitis. Good nutritional status can improve the patient's tolerance to treatment.