Objective To investigate the value of feasibility and the prognosis evaluation of multi-slice spiral CT in esophageal carcinoma resection. Methods The preoperative multi-slice spiral CT data of 108 patients with esophageal carcinoma treated in the hospital from Jan. 2015 to Oct. 2016 were retrospectively analyzed. The value of multislice spiral CT in evaluating the feasibility of surgery, diagnosis of tumor invasion and preoperative clinical stage, and the effect of indexes displayed by spiral CT and clinical stage on the prognosis were analyzed. Results Multi-slice spiral CT evaluation showed that all 108 cases of patients could be given the surgical resection while actually there were only 3 cases without being given the surgery, and the accuracy of multi-slice spiral CT evaluation was 97.22%. The sensitivity, specificity and accuracy of multi-slice spiral CT examination were 90.00%, 88.24% and 88.89% respectively in diagnosis of tracheal and bronchial invasion, and were 91.67%, 93.05% and 92.59% respectively in diagnosis of pericardial invasion, and 89.74%, 92.75% and 91.67% respectively in the diagnosis of aorta and adjacent large vascular invasion. The accuracy of multi-slice spiral CT in diagnosis of clinical stage was 89.81%. Multi-slice spiral CT detected that the survival rate of patients with lesions length ≤ 5.0cm, the maximum lesion diameter ≤ 3.0cm and the clinical stage with I and II were significantly higher. Conclusion The accuracy rates of multislice spiral CT are high in the diagnosis of tumor invasion and preoperative clinical stage of patients with esophageal carcinoma, and the spiral CT indexes and clinical stage can be used to evaluate the prognosis of surgery.