Objective To analyze the 3-year prognosis characteristics of Tibetan patients with stage Ⅲ esophageal cancer treated by radical esophagectomy and summarize the influencing factors. Methods The clinical data of 90 Tibetan patients with stage Ⅲ esophageal cancer admitted to our hospital from March 2016 to March 2019 were retrospectively analyzed, and their 3-year survival was analyzed. According to the patients′ prognosis, they were divided into good prognosis group and bad prognosis group. The baseline clinical features of the two groups were compared and multivariate Logistic regression analysis was used to summarize the related factors affecting the prognosis of the patients.Results Of the 90 patients, 35 (38.89%) had no disease for 3 years after operation. Among the 55 patients with poor prognosis, 23 had local recurrence, 21 had distant metastasis and 11 died. Multivariate Logistic regression analysis showed that middle thoracic lesions, severe adhesion, positive lymph node number ≥3, T4a stage, N1 stage, stage III C, and no adjuvant treatment after operation were all independent risk factors that affected the prognosis of Tibetan patients with stage III esophageal cancer after radical esophagectomy (P<0.05). Conclusion The prognosis of Tibetan patients with stage Ⅲ esophageal cancer after radical operation is not satisfactory for 3 years, and the tumor location, adhesion state, lymph node metastasis, TNM stage and adjuvant therapy are all related to the prognosis of the patients.