Abstract: Objective To analyze the effect of Xianchan Tablets combined with chemotherapy in treatment of elderly patients with esophageal cancer. Methods Sixty-eight elderly patients with esophageal cancer treated in the hospital were selected by digital random grouping, including 34 cases in the control group and 34 cases in the observation group. The control group was treated with general chemotherapy regimen, while the observation group was given Xianchan Tablets combined with chemotherapy. The treatment effects of the two groups were observed and compared. Results The treatment response rate was higher in the observation group than that in the control group, and the difference was statistically significant(91.2% vs. 70.6%, P < 0.05). After treatment, the immunoglobulin A(IgA), CD3⁺, neuron specific enolase(NSE), carcinoembryonic antigen(CEA)indexes of two groups showed significant differences(P < 0.05). Follow-up within 3 months after treatment showed that there was a significant difference in the quality of life score between the observation group and the control group(P < 0.05). The incidence of adverse reactions after treatment was 14.7% in the observation group and 11.8% in the control group, but no significant difference between the two groups was observed(P > 0.05). Conclusion Chemotherapy combined with Xianchan Tablets has significant efficacy in the clinical treatment of elderly patients with esophageal cancer, which can improve serum tumor markers and immune function indicators, without adverse reactions increasing.