Abstract: Objective To study the survival of patients with advanced esophageal squamous cell carcinoma （ESCC） in first-line chemotherapy and the factors related to the prognosis. Methods Clinical data about 139 advanced ESCC patients with 124 males and 15 females who received first-line chemotherapy in our hospital from January 2009 to August 2014 were retrospectively analyzed. The distribution of age range was 39 to 78 years old with median age of 58 years old. Kaplan-Meier method was used to calculate the overall survival （OS）. Univariate analysis and Cox regression analysis were used to detect the influence factors of survival and prognosis. Results The response rate of 139 patients with chemotherapy was 46.8% with 1-year， 3-year， 5-year survival rates of 55.4%， 15.8%， 4.5%， respectively. The median OS of patients with advanced ESCC in first-line chemotherapy was 13.9 months. According to the results of univariate and COX multivariate analysis， OS of patients with advanced ESCC was closely associated with liver metastasis （P=0.028）， curative effect of first-line chemotherapy （P=0.001） and thoracic radiotherapy （P=0.000）. Conclusion Liver metastasis, curative effect of first-line chemotherapy and thoracic radiotherapy have important influences on the prognosis of patients with ESCC. The patients who are absence of liver metastasis have better prognosis. It is beneficial to survival if patients have effective curative effect of first-line chemotherapy and receive thoracic radiotherapy.