Objective: To explore the evaluation value of esophageal barium meal angiography combined with computed tomography (CT) in short-term and long-term prognosis of patients undergoing esophageal cancer radiotherapy. Methods: A retrospective analysis was performed on the clinical data of 96 patients who underwent esophageal cancer radiotherapy in the hospital between June 2023 and June 2024. Before radiotherapy, after radiotherapy and during re-examination, all underwent esophageal barium meal angiography and CT scan. According to the results of esophageal barium meal angiography, the remission rate was calculated. The patients with complete remission and partial remission were included into good short-term efficacy group, while those with stable disease and disease progression were included into poor group. After 1 year of follow-up, 1-year survival rate was statistically analyzed. The survival patients were included into good prognosis group, while death patients were included into poor prognosis group. CT scan results (long diameter, short diameter, volume and maximum wall thickness of lymph nodes) were compared between good efficacy group and poor group and between good prognosis group and poor prognosis group before and after radiotherapy, the relationship between the above indexes and short-term/long-term prognosis was explored by multivariate Logistic regression analysis, and their evaluation value in short-term/long-term prognosis was analyzed. Results: The results of esophageal barium meal angiography showed that overall remission rate of patients" condition and 1-year survival rate were 80.21% and 75.00%, respectively. After radiotherapy, long diameter, short diameter and volume of lymph nodes in good efficacy group were lower than those in poor group (P<0.05), and which were lower in good prognosis group than poor prognosis group (P<0.05). The long diameter, short diameter and volume of lymph nodes were all independent risk factors of short-term and long-term prognosis in patients with esophageal cancer after radiotherapy (P<0.05). The results of ROC curves analysis showed that AUC values of lymph node long diameter, short diameter and lymph node volume for predicting prognosis were 0.690, 0.718 and 0.680, lower than that of combined detection (0.800), and the differences were statistically significant (P<0.05). Conclusion: Esophageal barium meal angiography combined with CT has higher diagnostic value in short-term and long-term prognosis of patients undergoing esophageal cancer radiotherapy. The analysis on short diameter, long diameter and volume of lymph nodes can predict poor prognosis of patients.