Abstract: Esophageal cancer, a malignant tumor with devastatingly high incidence and mortality rates, necessitates prompt efficacy evaluation and accurate prognosis prediction. Radiomics is an algorithmic approach that extracts insightful quantitative parameters from medical images, offering a trove of high-throughput imaging features. This technology demonstrates significant predictive value in esophageal cancer, holding immense promise for personalized treatment and patient evaluation. This article delves into the latest research advancements of computed tomography radiomics in both prognosis prediction and efficacy evaluation of this aggressive disease.