Objective To compare the dosimetry curative effect between simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and threedimensional conformal radiation therapy (3DCRT) for esophageal carcinoma. Methods 60 cases of patients with esophageal carcinoma who were treated by 3DCRT in our hospital during January 2010 to December 2012 were included into 3DCRT group, and another 60 cases treated by SIB-IMRT during January 2013 to February 2016 were included into SIB-IMRT group. The clinical data of all patients were collected. The dose distribution and conformal index (CI) of target region, dose homogeneity index (HI) and the dose received by involved organs were compared between the two groups, and the efficacy and safety of SIB-IMRT and 3DCRT were compared. Results ①Dmin, Dmean, V95 and D95% of target region, Dmin and Dmean of the gross tumor volume (GTV), Dmax, Dmin and Dmean of planning target volume (PTV) in SIB-IMRT group were higher than those in 3DCRT group (P<0.05). ②CI in SIB-IMRT group was higher than that in 3DCRT group while HI was lower than that in 3DCRT group (P<0.05). ③The spinal cord Dmax and lung V30 in SIB-IMRT group were lower than those in 3DCRT group and the lung V5 was higher than that in 3DCRT group (P<0.05). ④The incidence of radiation esophagitis in SIB-IMRT group was lower than that in 3DCRT group (P<0.05). Conclusion The treatment of esophageal carcinoma with SIB-IMRT is with high homogeneity, good conformity, low dose received by involved organs and high safety.