Objective To study the effect of fast track surgery (FTS) in patients undergoing thoracoscopic combined with laparoscopic resection of esophageal carcinoma and cervical anastomosis. Methods 84 patients undergoing thoracoscopic combined with laparoscopic resection of esophageal carcinoma and cervical anastomosis in our hospital from February 2016 to February 2017 were included in the study. By the random number method, they were divided into two groups, 42 cases in each group. A group was given routine intervention during perioperative period, while B group were given FTS during perioperative period. The intraoperative blood loss, average surgery time, number of dissected lymph nodes, postoperative fluid infusion volume, ventilation time, chest tube and urinary catheter retention time, hospitalization time, immune function related indexes, stress indexes, complications and mortality rate were compared between the two groups. Results There were no death cases and significant differences between the two groups in the intraoperative blood loss, number of dissected lymph nodes and postoperative urinary catheter retention time (P＞0.05). The average surgery time, postoperative fluid infusion volume, ventilation time, chest tube retention time, hospitalization time and fasting time of B group were significantly shorter or less than those of A group (P＜0.05). There were no significant differences in IgA, IgG and IgM between the two groups before surgery and on the 1stday after surgery (P＜0.05) while those in B group on the 7th day after surgery were significantly higher than those in A group (P＜0.05). There were no significant differences between two groups in CRP, fasting blood glucose, IL-6 and plasma cortisol (P＞0.05), while those in B group on the 7thday after surgery were significantly higher than those in A group (P＜0.05). The incidence of postoperative complications in B group was significantly higher than that in A group (33.33% vs 7.14%) (P＜0.05). Logistic multivariate analysis showed that no FTS, postoperative little fluid infusion and short ventilation time were the risk factors for longer hospital stay (P＜0.05). Conclusion The application of FTS in patients undergoing thoracoscopic combined with laparoscopic resection of esophageal carcinoma and cervical anastomosis can shorten the surgery time, postoperative ventilation time, chest tube retention time and hospitalization time, relieve stress response and reduce the effect on immune function, with few complications. It also can promote the early recovery of patients after surgery.