Abstract: Objective To investigate the effect of neoadjuvant chemotherapy of paclitaxel and cisplatin on the surgical risk and prognosis of patients with stage Ⅲ esophageal cancer. Methods From January 2009 to June 2012， 140 esophageal cancer patients with stage Ⅲ were divided into simple operation group（n=78） and neoadjuvant chemotherapy group（n=62）， respectively. The neoadjuvant chemotherapy group received paclitaxel plus cisplatin chemotherapy regimen before operation（paclitaxel 135 mg／m2， d1； cisplatin 30 mg／m2， d1-d3, 21 days a cycle for two consecutive cycles）. The operation was performed 4 weeks after chemotherapy. The surgical resection rate， postoperative complications and overall survival（OS） were compared between both groups. Results Among 62 patients receiving neoadjuvant chemotherapy， 4 cases got CR, 34 cases got PR, 21 cases were in SD, 3 cases were in PD and the effective rate of 61.3％. The main side effects were leukopenia, digestive reaction, hepatic and renal dysfunction and hair loss in grade 1-2. The radical resection rate of neoadjuvant chemotherapy group was 91.9％（57／62）， higher than 69.2％（54／78） in the simple operation group（P=0.001）. There was no perioperative death in both groups. The incidence of postoperative complications of neoadjuvant chemotherapy group and simple operation group were 30.6％ and 25.6％ without statistical significance（P=0.512）. The new adjuvant chemotherapy group showed significantly better median OS compared to the simple operation group（17.8 months vs. 14.2 months P=0.016）.Conclusion In the treatment of stage Ⅲ esophageal cancer， neoadjuvant chemotherapy is helpful to improve tumor resection rate， without increasing the incidence of complications， and can effectively improve the clinical efficacy and OS， which is worthy of clinical application.