Objective To explore the symptom group composition and dynamic change track of patients with esophageal cancer during chemotherapy and provide evidence for symptom management of patients with esophageal cancer during chemotherapy. Method A total of 168 patients with esophageal cancer treated by chemotherapy in Nantong Cancer Hospital from June 2021 to December 2022 were selected as the study objects. General data questionnaire Anderson symptom assessment scale and symptom supplement questionnaire were used at the first admission T1 first chemotherapy T2 second chemotherapy T3 and last chemotherapy T4 . Symptom cluster were extracted by exploratory factor analysis. Result There were 12 20 22 and 18 symptoms with an incidence greater than 20% at each time node from T1 to T4 respectively. The incidence ranged from 12. 50% to 94. 12%. Exploratory factor analysis revealed Three five six and six symptom cluster were extracted from T1 T2 T3 and T4 respectively during chemotherapy for patients with esophageal cancer. Among them sleep disorder symptom group cognitive-related symptom group and psychoneurotic symptom group persisted from T1 to T4 pain symptom group digestive tract symptom group existed from T2 -T4 . Activity tolerance symptom group existed in T3 - T4 . Conclusion Patients with esophageal cancer have multiple symptoms and high incidence during chemotherapy and the composition of T3 and T4 symptom cluster is relatively stable. Nurses should pay attention to the symptom cluster of postoperative patients with esophageal cancer during chemotherapy and take appropriate measures to actively intervene to alleviate various symptoms so as to reduce the impact on patients.