Objective To retrospectively analyze and compare the nutritional status, adverse reactions, costs, and prognosis of esophageal cancer patients with or without tube feeding nutritional support during concurrent chemoradiotherapy.Methods Clinical and follow-up data of 62 patients with concurrent chemoradiotherapy for esophageal cancer at Hunan Cancer Hospital were collected from January 2013 to December 2022. The patients were divided into the tube feeding group and the non-tube feeding group. The nutritional status, costs, and prognosis of patients in both groups during concurrent chemoradiotherapy for esophageal cancer were compared.Results The number of completed cycles of concurrent chemotherapy and the cases with completed concurrent immunotherapy were higher in the tube feeding group than in the non-tube feeding group (P<0.05). There were no differences in the remaining clinical characteristics between the two groups (P>0.05). The cases of Nutritional Risk Screening (NRS) 2002 scores≥3, with ≥3 grade radiation esophagitis, bone marrow suppression and esophageal perforation in the non-tube feeding group was significantly more than in the tube feeding group (P<0.05). The average time for the lowest hemoglobin level appeared since concurrent chemoradiotherapy was 33.5 days in the tube feeding group and 27.25 days in the non-tube feeding group (P<0.05). The average time for the lowest platelet level appeared since concurrent chemoradiotherapy was respectively 26.43 days and 20.03 days in the tube and non-tube feeding group (P<0.05). The average time of interruption of radiation therapy in the tube feeding group was significantly shorter than in the non-tube feeding group (P<0.05). The proportion of nutrition costs was higher in the tube feeding group than in the non-tube feeding group, but the proportion of antibacterial drug costs and cytokine costs was lower in the tube feeding group than in the non-tube feeding group (P<0.05). Kaplan-Meier survival curves showed that the median PFS was 37.08 months in the tube feeding group and 18.35 months in the non-tube-feeding group, while the median OS was 59.28 months and 24.16 months, respectively, with statistically significant differences (P<0.05).Conclusion Tube feeding nutrition therapy improves the nutritional status of patients receiving concurrent chemoradiotherapy for esophageal cancer, reduces the incidence of serious adverse reaction and the interruption time of radiotherapy, delays the time to the appearance of the lowest hemoglobin and platelet levels, increases the completion rate of concurrent chemoradiotherapy, and reduces the cost of adjuvant medications, so as to leads to a better prognosis.