Esophageal cancer is one of frequent malignant tumors worldwide. As a noninvasive technique, computed tomography (CT) perfusion imaging could be valuable to assess the microcirculation of esophageal cancer in vivo. Recently, multidetector row CT (MDCT) perfusion imaging has sparked new interest in the assessment of the microcirculation of esophageal cancer, and therapeutic effects of chemoradiotherapy on this tumor. In this paper, we reviewed the status quo of perfusion imaging with MDCT on esophageal cancer.