Introduction: To identify risk factors for postoperative morbidity and mortality in patients undergoing esophagectomy for esophageal cancer. Design and patients: The population comprised 159 patients with locally advanced esophageal cancer, undergoing esophagectomy between January 1985 and December 2004. Results: Infections were the main cause of both complications and postoperative mortality. The 54% of our patients presented serious complications. The mortality of the series was 12.5%. Multiorganic failure secondary to sepsis was the more frequent cause of death. The postoperative complications showed a significant association with: alcoholism (p < 0.04), hepatic cirrhosis (p < 0.03), the location of the tumor in middle third of the esophagus (p < 0.04), and the APACHE II score greater of 10 (p < 0.003). Mortality was associated significantly with the presence of chronic pulmonary disease (p = 0,03) and with an APACHE II score superior to 10 (p = 0,02). Conclusions: The APACHE II score superior to 10 can be used so much as prognostic factor of mortality like of serious complications. Chronic obstructive pulmonary disease is a risk factor for postoperative mortality. Alcoholism, hepatic cirrhosis and the location of the tumor, are factors associated to postoperative serious complications. © 2009 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L.