Abstract: Obj ective To evaluate the allocation of homeochronous operative treatment for synchronous primary cancer of esophagus and lung.Methods 20 patients with synchronous prima-ry cancer of esophagus and lung were performed with curative resections of esophagus and lung syn-chronously.Surgical approaches included one incision through left thorax,one incision through right thorax,two incisions though upper abdomen and right thorax,with 7,8 and 5 cases respectively. Results 20 patients completed surgery and 5 of them reported postoperative complications.Accord-ing to the surgical approach,the operative time,blood loss,mean volume of drainage fluid and in-dwelling time significantly reduced in approaches of one incision through left thorax and one incision through right thorax (P<0.05 orP<0.01).2 patients lost to follow up and 1,3,5 years survival rate were 67.9%,47.4%,44.4%respectively.Conclusion Homeochronous operative treatment is feasible for synchronous primary cancer of esophagus and lung.