Esophageal cancer is a gastrointestinal malignancy with a high incidence and poor prognosis worldwide, with about 40% of cases concentrated in China, and the 5-year survival rate is less than 20%. Traditional imaging methods have obvious limitations in precision diagnosis and treatment, but PET/CT radiomics provides a new perspective for the accurate staging, dynamic monitoring of treatment response and individualized prognosis prediction of esophageal cancer by extracting and analyzing the morphological, metabolic and texture characteristics of tumors through high-throughput. This article systematically reviews the research progress of 18F-FDG PET/CT radiomics in the diagnosis and treatment of esophageal cancer, discusses its potential for cross-integration with genomics and dosimics, and looks forward to the future development direction, in order to provide more comprehensive theoretical support for clinical translation.