Abstract: Objective To examine influential factors of esophageal cancer among residents in Hebei province and to provide scientific evidences for prevention of esophageal cancer.Methods A hospital-based case-control study was conducted among 208 esophageal cancer patients and 210 non-digestive tract disease patients recruited at the Fourth Hospital of Hebei Medical University from June 2009 to May 2011.Results There were singificant differences in smoking,alcohol consumption,eating hot and hard food,eating speed,regular eating time,eating mildew ed food,taking fruit and fresh vegetables,taking beans and bean product,and taking milk and dairy product betw een the case and the control groups(P< 0.05 for all).The average scores of depression,anger,intrinsic anger,and reason in the cases were 44.30±7.47,24.74±6.71,14.71±2.51,and 42.19±6.50 and higher than those in the controls (40.47±6.87,22.58±5.00,13.82±2.25,and 40.83±3.58) (P< 0.01 for all).The average score of social support in the cases was 16.24±3.20,low er than that in the control group(17.53±2.13) (t=4.867,P=0.000).Multinomial logistic regression analyses show ed that living in rural area,having a family history of esophageal cancer,having bad family relationship,smoking more than 20 cigarretes a day,eating hard food,eating mildew ed food,and with high scores of reason,anger and depression were risk factors of esophageal cancer.Eating beans and its products frequently,drinking tap water,and with a high score of social support were protective factors of esophageal cancer.Having a family history of esophageal cancer,smoking more than 20 cigarrettes a day,eating hard food,eating mildew ed food,w ith high scores of reason and anger were risk factors of esophageal cancer for male residents.Eating beans and its products and with a high score of social support were protective factors of esophageal cancer for male residents.Eating hot and hard food and with a high score of depression were risk factors of esophageal cancer for female residents.Drinking tap water,eating fruits frequently,and with a high social support score were protective factors of esophageal cancer for female residents.Conclusion The incidence of esophageal cancer is strongly associated with environment,diet,smoking,genetic factors,and type-C behavior among the residents in Hebei province and the male and female residents have different risk factors.Specific preventive measures should be taken in different populations.