Background: Southern Hebei Province has one of the highest incidences of oesophageal cancer in the world. This study describes a single-centre experience with oesophagectomy for this condition. Methods: The reported articles on surgical treatment for cancer of the oesophagus and gastric cardia from a single department between September 1952 and December 2000 were summarized and die results compared. Results: Between September 1952 and December 2000, the resectability rate increased from 78.8 to 96.0 per cent for oesophageal cancer and from 69.6 to 94.8 per cent for cancer of the cardia. The surgical mortality rate decreased from 4.6 to 1.1 per cent. There was little change in the overall 5-year survival rate; it increased from 21.2 to 23.9 per cent for patients with oesophageal cancer and from 15.2 to 17.6 per cent for those with cancer of the cardia. Conclusion: The rate of postoperative complications and deaths following oesophagectomy for cancer has fallen steadily over the past five decades but long-term survival remains disappointing. Improved survival is likely to be dependent on earlier diagnosis and adjunctive therapies.