Abstract: Objective To explore the effect of personalized diet nursing for elderly patients with advanced esophageal cancer. Methods A total of 54 elderly patients with advanced esophageal cancer in our hospital from January 2018 to December 2019 were divided randomly into control group(27 cases,routine diet nursing) and observation group(27 cases,routine diet nursing + personalized diet nursing). The personalized diet nursing measures were designed based on the patients' clinical symptoms, personality, communication ability and related basic disease, then the nursing effect of the two groups was compared. Results The clinical efficacy rate in the observation group was 81.5%,which was higher than that of the control group(74.1%),but the differences between the two groups showed no statistical significance(P>0.05). The radiation esophagitis and myelosuppression were 44.4% and 18.5% in the observation group,51.9% and 25.9% in the control group,which was also no significant difference between two groups(all P>0.05). On anorexia,the observation group(40.7%) was better than the control group(70.4%, P<0.05). The life qualities of the patients were evaluated according to 5 functional areas and 1 overall life quality area of EORTC QLQ-C30. It showed that the physical function,role function and cognitive function in the observation group were all significantly higher than those in the control group(all P<0.05). On nursing satisfaction,the observation group(92.6%) was higher than the control group(70.4%, P<0.05). Conclusion Personalized diet nursing intervention applied to the elderly patients with advanced esophageal cancer can reduce the adverse reaction of radiotherapy,improve the quality of life,and promote the compliance and nursing satisfaction.