Objective To explore the feasibility of 64 slice spiral CT in the evaluation of thoracic esophageal carcinoma excision. Methods A total of 39 patients with thoracic esophageal carcinoma diagnosed by surgery pathology in the hospital were selected as the research objects. All of the chosen patients received 64 slice spiral CT before operation. The surgical staging and the situation of invasion of the surrounding tissues in the two groups were observed and were compared with pathology. Results Compared with the surgery and pathology, the results of preoperative spiral CT showed that there were 32 cases of radical mastectomy and the coincidence rate was 82.05%; 6 cases of partial resection of the esophageal carcinoma and the coincidence rate was 15.38% and 1 cases not able to receive surgical treatment and the coincidence rate was 2.56%; 64 slice spiral CT showed that there were 8 cases with tracheal invasion, 4 cases of violations of the pericardium and 7 cases with invaded thoracic aorta and the coincidence rates respectively were 88.89%, 66.67% and 87.5%; In TNM staging of 64 slice spiral CT in the diagnosis of esophageal carcinoma, the diagnostic accuracy in tage I to II was 66.67%, in stge III was 77.78% and in stage IV was 96.30%. Conclusion The accuracy of 64 slice spiral CT in the diagnosis of invasion of surrounding tissues and TNM staging of patients with thoracic esophageal carcinoma is relatively higher. It is of high application value in the preoperative determination of treatment scheme.