Objective To explore the levels and relationship of symptom distress and supportive care needs among esophageal cancer patients after esophagectomy in recovery stage, and to provide reference for targeted intervention. Methods A total of 167 discharged patients with esophageal cancer after esophagectomy were recruited and investigated using a self-designed general information questionnaire, the M.D. Anderson Symptom Inventory Gastrointestinal Cancer Module and the Supportive Care Needs Su-rvey. Results The incidence rates of 18 symptoms were between 39.5% and 79.0%, and the median score of severity was 2.06. The incidence rates of interference in 6 aspects of life ranged from 50.9% to 67.7%, and the median score of interference was1.83. The total score of supportive care needs was 86.79±27.18. Symptom severity and interference were positively correlated with supportive care needs （r=0.481,0.541,P＜0.01 for both）. Conclusion Patients with esophageal cancer after esophagectomy in recovery stage experience several symptoms and are distressed. They need hygiene and information related supportive care. The more severe the symptoms and interference, the higher need. Medical staff should strengthen evaluation and provide targeted intervention to meet the needs of patients and alleviate their symptom distress.