Abstract： Objective To study the effect of hyperbaric oxygen (HBO) coupled with radiation therapy on the expression of survivin in patients with esophageal carcinoma(EC). Methods The expression of survivin was measured by immunohistochemical (SP) method in 65 cases of EC, and in 39 people with normal esophageal mucosa. Results The expression rate of survivin was 70. 8％ (46/65)in patients with EC, while the expression rate of survivin was only 0. 05％ (1/20) in the normal mucosa tissue. The expression of survivin was closely correlated with lymph node metastasis (LNM). The positive rate of survivin expression in LNM patients was significantly higher than that of the patients without LNM ( P ＜ 0. 05 ). Clinical symptoms in the patients treated with HBO coupled with radiotherapy improved considerably, when compared with those of the patients treated only with radiotherapy. The positive rate of survivin decreased with statistical significance (P ＜0. 05 ). Conclusions The high expression rate of survivin was closely correlated with the growth and metastasis of EC. HBO coupled with radiotherapy could enhance the therapeutic efficacy of the disease.