Objective To analyze the inpatient service utilization and burden of esophageal cancer patients, and explore the changes in the reimbursement level of esophageal cancer in the New Rural Cooperative Medical Care system in the province. Methods Select all the NRCMS's data of esophageal cancer patients in 2013-2017, do statistical analysis of the hospitalization, the average hospitalization days, the composition of the average cost, and the reimbursement and reimbursement expenses of the NRCMS about esophageal cancer. Results In 2017, the number of reimbursement for esophageal cancer per rural 100,000 people in Anhui Province was 20.17 times that of 2013, and the compensation level increased to 312,716 yuan; The proportion of medical expenses and consumables fee in patients' hospitalization expenses showed a downward trend, surgery fees and treatment fees showed an upward trend, and the proportion of medical expenses paid by themselves was still as high as 55% in 2017; The Gini coefficient of total medical expenses, compensation expenses and hospitalization days are at the alert level. Conclusion The effectiveness, efficiency and fairness of medical services have been greatly improved, but we must continue to deepen medical reform and take comprehensive measures to promote a more rational flow of treatment and reduce unfairness.