Objective To explore the composition of symptom clusters in esophageal cancer patients, construct a symptom network, explore core symptoms, and provide reference for the development of symptom management programs.Methods Convenient sampling method was used to select 255 esophageal cancer patients for investigation, and their symptom occurrence was assessed by using the general information questionnaire, the Chinese version of the 30-item European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the 18-item Quality of Life Questionnaire, Esophageal Cancer-Specific (QLQ-OES 18); symptom clusters were extracted by exploratory factor analysis, and symptom networks were constructed and the centrality indexes were analyzed by using the language of R.Results There were six symptom clusters extracted from esophageal cancer patients, which were fatigue appetite-related symptom cluster, eating difficulty-related symptom cluster, respiration-related symptom cluster, diarrhea reflux-related symptom cluster, speech-related symptom cluster, and pain-related symptom cluster. Fatigue, decreased appetite, pain, nausea, vomiting, and difficulty swallowing were the core symptoms.The intensity and tightness of fatigue (rs=4.452 70, rc=0.012 61) and decreased appetite (rs=4.318 11, rc=0.012 57) were relatively high.Conclusion Healthcare professionals should pay attention to the changes in patients′ symptoms, intervene throughout the entire process of symptom clusters and core symptoms, combine symptom clusters with network centrality indicators, and develop precise symptom management plans to improve patients′ quality of life during treatment.