Objective To explore the risk factors of malnutrition in patients with esophageal cancer based on multidimensional nutritional status assessment. Method Clinical data of 106 patients with esophageal cancer admitted to the Oncology Department of Hai'an Hospital of Traditional Chinese Medicine from March 2019 to March 2023 were retrospectively analyzed. Through the global leadership initiative on malnutrition the Global Leadership Initiative on Malnutrition GLIM European Society for Clinical Nutrition and Metabolism 2015 ESPEN 2015 and patient-generated subjective global assessment PG-SGA were used to evaluate the nutritional status of 106 patients with esophageal cancer and the influencing factors of malnutrition were analyzed by binary Logistic regression. Result There were 21 cases of malnutrition assessed by GLIM 18 cases of malnutrition assessed by ESPEN 2015 19 cases of malnutrition assessed by PG-SGA and 27 cases of malnutrition assessed by multidimensional comprehensive assessment. Binary Logistic regression analysis showed that age > 60 years old comorbidities family history pathological stage Ⅲ-Ⅳ course of disease ≥ 12 months gastrointestinal symptoms ≥2 items poor diet behavior and Kanofsky performance score KPS < 70 points were all risk factors for malnutrition in patients with esophageal cancer P < 0. 05 . Conclusion Evaluating the nutritional status of esophageal cancer patients based on multidimensional nutritional status has good clinical value age > 60 years comorbidities family history pathological stage Ⅲ - Ⅳ duration of the disease >12 months gastrointestinal symptoms ≥2 poor dietary behaviors and KPS < 70 are risk factors for malnutrition in patients with esophageal cancer which need to be emphasized more in the clinic.