Aim: To explore the associations of diffusion-weighted magnetic resonance imaging (DWI) measurements with the therapeutic effect (TE) on and survival of esophageal carcinoma patients treated with chemoradiotherapy (CRT). Methods: From March 2010 to December 2011, 77 patients were prospectively enrolled into a cohort study. DWI was performed at the beginning and 1-3 months after CRT. The immediate post-CRT TE was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST). The associations between the disappearance status of hyperintense expression (HE) in DWI and the apparent diffusion coefficient (ADC) of DWI with the complete response (CR) as TE and survival were analyzed. Results: 3 patients were excluded due to the absence of HE in DWI. Analysis of the remaining 74 patients indicated that their ADC values were significantly improved from 1.64 +/- 0.48 to 2.65 +/- 0.58 mm(2)/s from -pre-CRT to post-CRT (p = 0.000). Both univariate and multivariate Cox model analyses showed that high postCRT ADC values and the disappearance status of HE associated significantly with the TE (CR rate) and survival. Conclusions: DWI examination could afford useful markers to predict the treatment response as well as the survival of patients with esophageal squamous cell carcinoma. The non-disappearance of HE in DWI and low ADC values after CRT were risk factors.