Background: McKeown first described two autopsy cases of esophageal small cell carcinoma (SMC) in 1952; about 230 cases have since been reported in the literature. Small cell carcinoma has been reported to account for 0.4% to 7.6% of all esophageal malignancies. SMC of the esophagus as regarded as having a poor prognosis with frequent systemic dissemination. Choice of treatment remains controversial. Material and Method: From August 1987 to December 1998, a review of the records and histologic sections of 8 patients with primary small cell carcinoma of the esophagus seen in 11 years was undertaken. Result: Small cell carcinoma of the esophagus constituted 1.5% of all esophageal cancers. The median age was 61.5 years(range from 42 to 71 years). Seven patients were male, tumor was mainly located in the middle and lower thirds(6 cases) of the esophagus. Pure SMC is 5 cases, and mixed SMC is 3 cases. Operative procedure were as follow: transthoracic esophagectomy with thoracic or cervical reconstructon in 7 patients, transhiated esophagectomy with cervical reconstruction in one. The operative death was none. Adjuvant chemotherapy was performed in 7 patients except one who had poor general condition. Recurrence was observed in 4 patients(mediastinal LN, abdominal LN, SCN, bone). The overall median survival was 15.9 months. Only one patient survived for more than 5 years. Conclusion: We considered that esophageal SMC should be regarded as a systemic disease, and multimodality treatment including chemotherapy should be used. Surgery may be offered in selected patients to manage local disease as part of a chemotherapy based treatment program.