Abstract: Esophageal squamous cell carcinoma (ESCC) is highly heterogeneous. Neoadjuvant chemoradiotherapy (nCRT) is the preferred treatment mode for locally advanced operable patients, but not all them can benefit from this therapy modality. Accurate identification of benefit group before or during treatment is of great significance for the formulation or timely adjustment of overall treatment strategy. As a functional imaging, ¹⁸F-FDG PET/CT contains rich tumor biological information, which can reflect the efficacy of nCRT before the change of tumor histomorphology. The authors provided a review of the progress in predicting the nCRT efficacy of ESCC using ¹⁸F-FDG PET/CT, with the aim of screening the beneficiaries of nCRT for locally advanced ESCC operable patients from a functional imaging perspective.