Abstract: Radiation-induced esophageal injury (RIEI) is a common dose limiting complication in chest tumor radiotherapy, and its pathogenesis involves direct radiation-induced DNA damage, oxidative stress, and chronic inflammatory cascade reactions. The authors systematically elaborates the pathological progression of RIEI, with a focus on the multi-level interaction mechanisms involving key regulatory cytokines (such as tumor necrosis factor-α, interleukin (IL)-1, IL-6, IL-8, and transforming growth factor β (TGF-β)) and signaling pathways (including nuclear factor-κB, TGF-β1, TGF-β/Smad, and mitogen-activated protein kinase) in RIEI. The authors aims to provid a theoretical basis for developing targeted intervention strategies and also point the way for future research on precision radioprotection.