To assess the treatment outcome after radiotherapy with or without chemotherapy for inoperable locally advanced (T4) esophageal cancer (EC), a retrospective analysis was performed. We enrolled 37 patients with T4 EC and analyzed 35 patients. A total of 28 patients were treated with radiotherapy and chemotherapy (median dose, 60 Gy) and seven patients were treated with radiation alone (median dose, 60 Gy). Many mainly received high-dose cisplatin (CDDP) and 5-fluorouracil (FU) or continuous infusion of low-dose CDDP and 5-FU. Among the 35 patients, there were eight survivors and 27 deaths. The median follow-up period was 15.5 months (3.5 to 74 months). The one-year, 3-year, and 5-year survival rates were 37.5%, 10.0%, and 10.0%, respectively, with a median survival time (MST) of 7.3 months. When the patients were divided into two groups, a complete response (CR) group and a non-CR group, MST was 16.5 and 6.2 months, respectively, showing significant differences between the two groups (p=0.0317). CR patients showed more satisfactory long-term outcomes than non-CR patients.