OBJECTIVE： To compare therapeutic efficacy and safety of different chemotherapy regimens in the treatment of small cell esophageal cancer. METHODS： In retrospective analysis， 58 patients with small cell esophageal cancer were divided into group A（18 cases），B（26 cases） and C（14 cases） according to chemotherapy regimens. Group A was given Cisplatin injection 75 mg/m2 intravenously， d1-3+Paclitaxel injection 175 mg/m2，d1-3. Group B was given Cisplatin injection 30 mg/m2 intravenously，d1-3+Etoposide injection 100 mg/m2，d1-3. Group C was given Vinorelbine tartrate injection 25 mg/m2 intravenously， d1-3+Gemcitabine hydrochloride for injection 1 000 mg/m2，d1-3. A treatment course of 3 groups lasted for 21 d， and they all received 2 cycles of treatment. Clinical efficacies， 1， 2， 3-year survival rate and the incidence of Ⅲ-Ⅳ degree toxic reaction （cough， fever， expectoration， shortness of breath， fatigue， chest pain， bone marrow suppression， gastrointestinal reactions） were compared among 3 groups. RESULTS： Total response rate and 1， 2， 3-year survival rate were in descending order： group C＞group B＞group A； the incidence of Ⅲ-Ⅳ degree cough， fever， expectoration， shortness of breath， fatigue， chest pain were in ascending order： group C＜group B＜group A， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of Ⅲ-Ⅳ degree myelosuppression and digestive tract reaction among 3 groups （P＞0.05）. CONCLUSIONS： Therapeutic efficacy and 1，2，3-year survival rate of vinorelbine combined with gemcitabine are significantly higher than those of cisplatin combined with paclitaxel or etoposide with better safety.